CaseReport2
CaseReport2
CaseReport2
ReportHistory
80-year-old male presenting with right upper quadrant pain and fever. The ultrasound was strongly suggestive of cholecystitis, but the sonographic Murphy’s sign was negative.
Exam
Nuclear medicine hepatobiliary scintigraphy. Following at least a 4 hour fast, the patient was injected with a dose of 4.8 mCi of Tc-99m mebrofenin. Imaging was performed in the anterior projection for 1 hour, imaging at 1 minute for frame.
Prior Study
Ultrasound from the same day
Findings & Impressions
Findings:
The liver shows good uptake and prompt excretion into the common bile duct and gut without gallbladder visualization. A “rim sign” is noted along the gallbladder fossa / adjacent liver parenchyma.
Impression:
Severe acute cholecystitis. The rim sign gives a 30-40% chance of gangrenous cholecystitis.
Recommendations:
For your training purposes, recommendations are not included in this report.
Acuity
Urgent: non-routine communication within 4 hours
The ordering clinician should be notified of these findings.
