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CT Findings in Acute Gangrenous Cholecystitis

Genevieve L. Bennett1, Henry Rusinek, Virna Lisi, Gary M. Israel, Glenn A. Krinsky, Chrystia M. Slywotzky and Alec Megibow

1 All authors: Department of Abdominal Radiology, New York University Medical Center, Tisch Hospital, Rm. HW202, 560 First Ave., New York, NY 10016.



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  		Fig. 1. —58-year-old man with acute gangrenous cholecystitis. CT scan with IV contrast material shows air in gallbladder lumen (arrow).

 


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  		Fig. 2. —86-year-old man with acute gangrenous cholecystitis. CT scan with IV contrast material shows intraluminal linear densities (black arrows) corresponding to intraluminal membranes. Note lack of contrast enhancement of gallbladder wall (open arrow). Pericholecystic inflammation (white arrow) and adjacent renal cyst (c) are visualized.

 


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  		Fig. 3A. —84-year-old woman with acute gangrenous cholecystitis. CT scan with IV contrast material shows irregularity of wall (black arrows) of gallbladder (g) and inflammation in pericholecystic fat (white arrow). s = stomach.

 


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  		Fig. 3B. —84-year-old woman with acute gangrenous cholecystitis. CT scan, more superior than A, shows loculated fluid attenuation abnormality adjacent to gallbladder, consistent with abscess (a). Defect in gallbladder wall is shown (black arrow). White arrow shows pericholecystic inflammation. s = stomach.

 


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  		Fig. 4. —89-year-old woman with acute gangrenous cholecystitis. CT scan with IV contrast material shows markedly distended gallbladder with irregular wall showing striated appearance with alternating areas of high (black arrows) and low attenuation (small white arrow). Large gallstone (asterisk) is present in gallbladder lumen. Large white arrow shows pericholecystic inflammation.

 


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  		Fig. 5. —58-year-old woman with acute nongangrenous cholecystitis. CT scan with IV contrast material shows markedly thickened gallbladder wall with alternating areas of high (black arrows) and low attenuation (short white arrow), giving striated appearance. Gallbladder wall appears regular and intact. Note enhancing vessel in gallbladder wall (long white arrow).

 


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  		Fig. 6A. —84-year-old woman with acute gangrenous cholecystitis. CT scan with IV contrast material depicts increased contrast enhancement of liver parenchyma adjacent to gallbladder fossa (arrows).

 


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  		Fig. 6B. —84-year-old woman with acute gangrenous cholecystitis. CT scan, more inferior than A, shows marked distention of gallbladder (g) with mural thickening (arrow).

 


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  		Fig. 7. —77-year-old man with acute nongangrenous cholecystitis. CT scan with IV contrast material shows mildly distended gallbladder with mild wall thickening (white arrow). Note increased enhancement of liver adjacent to gallbladder (black arrows).

 


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  		Fig. 8. —38-year-old woman with acute gangrenous cholecystitis. CT scan with IV contrast material shows extensive pericholecystic fluid (white arrows). Intraluminal linear high density corresponds to intraluminal membrane (black arrows).

 


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  		Fig. 9. —50-year-old woman with acute nongangrenous cholecystitis. CT scan shows pericholecystic fluid (arrows).

 

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