- MedPix™ TF Case: 9509 - Quiz Mode :: ::
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Patient is an 18-year-old girl, unknown parity, who presents to ER with acute right upper quadrant pain and fever. She has a family history of gallstones and currently takes oral contraceptives.

Download/Watch Video - Flash http://www.youtube.com/watch?v=N7VQApQKApk&feature=youtu.be or WMV http://rad.usuhs.edu/medpix/video/US_gallstone_shadowing.wmv

Temp 37.2 C, Pulse103, Respirations 28, BP 110/71

Tender to palpation in the right upper quadrant, described as 5/5 on a numeric scale.

White Blood Cell Count= 8.5
Hemoglobin= 14
Hematocrit= 42
Platelets= 276
Total Bilirubin= 0.6 mg/dL
Amylase= 27
Lipase= 226

Urine pregnancy test negative

Plain film radiographs failed to demonstrate suspicious soft tissue calcifications, masses, free air or evidence of ileus.

Ultrasound demonstrated thickening of the gall bladder wall without pericholecystic fluid. There were multiple shadowing mobile calcifications, but a single calcification in the neck of the gall bladder failed to move with changes in position, suggesting that it was impacted.

• Acute Cholecystitis
• Chronic Choleyctitis
• Cholangitis
• Gallbladder Mucocele
• Gallbladder Tumor

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