June 2008

Submitted by Skorn Ponrartana, MD, and and Ashley Wachsman, MD.

History: 86 year old woman with history of poorly controlled diabetes, hypertension, and lymphoma presents with right upper quadrant pain, nausea, vomiting and fever that began in the last 24 hours.

Ultrasound Images of the Abdomen (Click on pictures to see larger versions)

What are the pertinent findings?

1. Gallstones.
2. Gallbladder wall thickening.
3. Portal venous gas.
4. Pericholecystic fluid.
5. Air in gallbladder wall or lumen.
6. Dilated common bile duct.
7. All of the above.

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