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History: middle aged man with right upper quadrant pain. This is a case of acute calculous cholecystitis. Cholecystitis can be classified as either acute or chronic, and acute cholecystitis can be either calculous or acalculous. Calculous cholecystitis occurs in 95% of cases of cholecystitis, and acalculous cholecystitis occurs in 5% of cases of cholecystitis. This … Continue reading
History: 65 year old male with jaundice. This is a Klatskin tumor causing bile duct obstruction and biliary dilatation. A Klatskin tumor is a cholangiocarcinoma that arises at near the confluence of the right and left hepatic ducts and causes obstruction of bile duct outflow, leading to biliary dilatation as seen in the second image … Continue reading
History: 50 year old female with melanoma. This is a case of metastatic malignant melanoma to the gallbladder. Melanoma is the most common cancer to metastasize to the gallbladder, and it usually occurs in the setting of widespread metastatic disease. Melanoma metastases are usually hyperenhancing. The differential diagnosis in this case would include other causes … Continue reading
History: 50 year old female with abdominal pain with an incidental finding. Adenomyomatosis is focal gallbladder wall thickening secondary to hyperplastic smooth muscle proliferation and exaggeration of the Rokitansky-Aschoff sinuses. It is usually asymptomatic, incidental, and of little clinical importance. Cholecystectomy can be performed if patients are symptomatic. The differential diagnosis includes adenomatous polyp, and … Continue reading
History: 55 year old female with abdominal pain. This is the typical appearance of cholelithiasis (gallstones) on CT. There are multiple types of gallstones, including cholesterol stones (the most common type) and pigment stones. Ultrasound is usually the imaging method of choice to diagnose cholelithiasis, however, they can be seen on CT up to 80% … Continue reading
History: 50 year old male with severe chest pain has incidental finding on a CT of the thorax ordered for thoracic aortic dissection. Contrast material excretion by the gallbladder is called vicarious contrast material excretion (VCME). Vicarous contrast material excretion is technically defined as any excretion of contrast material in a way other than the normal … Continue reading
History: 56 year old man with new onset 12 hour history of abdominal pain, nausea and vomiting. This patient went on to endoscopic retrograde cholangiopancreatography (ERCP) and was found to have a large obstructing gallstone in the distal common bile duct. Sphincterotomy was performed, which is a common method of treatment for gallstone pancreatitis and … Continue reading
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