Radiology Teaching Files > Case 10083710

Patient: 45 year old male
History: Patient presented with right upper quadrant pain and fever for one week duration.

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Findings: Sonography revealed the following findings. Gall bladder was diffusely distended with echogenic sludge. Gall bladder wall was thickened with wall thickness measuring 5mm. There were multiple calculi the largest measuring 1.2cm. There was minimal pericholecystic fluid and pericholecystic oedema. Sonographic Murphys sign was positive.
Discussion: Cholecystitis is inflammation of the gall bladder that occurs most commonly because of an obstruction of the cystic duct due to cholelithiasis. Gall stones are 2-3 times more frequent in females resulting in a higher incidence of calculous cholecystitis in females. Incidence increases with age, the peak age being 40-60yrs. Patient presents with right upper quadrant pain radiating to the scapula with nausea ,vomiting and fever.The ultrasonographic diagnostic criteria can be classified into major and minor criteria. Two major or one major and two minor criteria need to be present to acheive a diagnosis. The major criteria include Gall bladder wall thickening more than 3mm, striated gall bladder wall, sonographic murphys sign positive, mucosal sloughing, pericholecystic fluid, intramural gas. Minor criteria include sludge within the gall bladder and gall bladder dilatation more than 5cm in transverse diameter.
nice case! thanks for posting it.--Rex Jakobovits, 2007-08-29
i want to explain that the sex prevelance is not been toward female in calcular cholecystitis. as in this case , the patient is male.--ADEL HOSNY, 2007-10-17
increase in the transverse diameter without sludge is anormal variant not aminor signe of cholecystitis osama shehata 9 11 2007--osama shehata, 2007-11-09
nice case!--samera begum, 2008-04-01
Very nice case! Although it would have been nice to learn what "murphys sign" is. It would have been great to have an explanation in the "discussion"-part of the case.--Nils Hoyer, 2009-03-02
Additional Details:

Case Number: 10083710Last Updated: 11-13-2009
Anatomy: Gastrointestinal (GI)   Pathology: Infection
Modality: USAccess Level: Readable by all users

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