  Case of the Week - Patient Summary 7345Peer Reviewed and Certified - | |
| Demographics: 41 y.o. Man | |
| History & Chief complaint: | |
| 41 year old male with diffuse vague abdominal pain. | |
| Physical exam and Laboratory: | |
| WBC . . . . . . . . . . 15k
ALK PHOS. . . . . . . . 68 IU/L AST . . . . . . . . . . 33 IU/L TBILI . . . . . . . . . 0.7 MG/DL ALT . . . . . . . . . . 57 IU/L AMYLASE . . . . . . . . 31 IU/L LIPASE. . . . . . . . 133 U/L | |
| Summary of Findings: | |
| CT and US demonstrate gallstones with gallbladder wall thickening and pericholecystic fluid collection.
Air within the gallbladder is in a non-dependent distribution. This represents air within the gallbladder. This can be seen as the "mercedes benz" sign on plain radiography. | |
| Differential Diagnosis: | |
| Air within the gallbladder can be secondary to emphysematous cholecystitis, chole-enteric fistula, surgical manipulation of the biliary ductal system or air within the gallstones. | |
| Diagnosis: | |
 Cholecystitis, with air in the gall stones. | |
| Confirmed by: gross specimen | |
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