Findings, case of 56 y/o man, acute RUQ pain

Imaging Findings

On initial ultrasound examination two weeks prior to presentation, the gallbladder was normal (arrow) with no evidence of stones.

The second abdominal ultrasound examination shows a markedly thickened gallbladder wall containing a layering echogenic fluid-fluid level.

Computed tomography demonstrates a high attenuation gallbladder wall (short black arrows) containing a layering high attenuation fluid-fluid level (long black arrow, see above link) representing blood or, less likely, pus. There is a small amount of pericholecystic fluid (long white arrow, see above link) as well as inflammatory changes in the fat inferior to the gallbladder (short white arrow, see above link).

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