A 36-year-old woman presented with pain in the epigastric region and right upper abdominal quadrant that lasted for two weeks. The pain did not remit after taking analgesics. She vomited once 7 days before. Clinical examination revealed abdominal pain on palpation. She was cardio-respiratory stable, in good general health condition without loosing weight.

Contrast-enhanced CT performed after the USS abdomen.What are the abnormalities you can see in this CT?What is the most likely diagnosis?



ANSWER

Adenocarcinoma of the gallbladder with wall calcifications and Liver metastases

Contrast-enhanced CT revealed calcifications in the thickened gallbladder wall.In a liver segment around the gallbladder a hypodense area was noted and hepatic parenchyma infiltration of a gallbladder adenocarcinoma was diagnosed. Hypodense oval lesions in liver segments IV, V, and VIII suggested metastases. Enlarged lymph nodes with central necrosis were depicted in the hepatoduodenal ligament, in the para-aortic and interaortocaval region.


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14 comments

  1. Anonymous Says:
  2. Liver abcess

     
  3. Anonymous Says:
  4. amoebic liver abscess

     
  5. kseniya-md Says:
  6. where is right kidney?

     
  7. Anonymous Says:
  8. hydatid cyst.

     
  9. Anonymous Says:
  10. hydatid cyst

     
  11. Anonymous Says:
  12. Porcelain gallbladder and abscess

     
  13. Anonymous Says:
  14. ehinococus

     
  15. Anonymous Says:
  16. liver abscess

     
  17. Anonymous Says:
  18. HCC

     
  19. f Says:
  20. i see a lot of calcium in the photo, like a liver cyst covered with calcium "hydatid cyst", and a calcified pancreas ...
    i suggest cystectomy with drainage by marcupialization or omentoplasty and a lot of wide spectrum antibiotics b4 and after the operation :P, ERCP would give us a lot of benefits specially with some CBC and Amylase lipase and a chest X-Ray is definitely needed

     
  21. Anonymous Says:
  22. hydatid cyst

     
  23. Codeine is a narcotic opioid drug like oxycodone and hydrocodone. It is similar in properties to these generic drugs. Findrxonline in his blog points out that It is a derivative of the opium plant and inevitably possesses similar characteristics like any other derivative of the opium like heroin and morphine. It is used for the treatment of mild to moderate pain and is used as an analgesic. It is also used as a cough suppressant and treats cough effectively as it possesses antitussive properties. It is a prescription and can be availed only through a prescription drug. However one can buy cheap Codeine online without prescription easily.

     
  24. hb Says:
  25. First of all, it is an abdominal contrast-enhanced CT, with only a cut that shows part of the liver, the gallbladder, the left kidney and part of the Spleen. We can see an enlarged liver with soft tissue lessions, 4 in this image, of less than 2 or 3 cms, with an aspect of "cow eye", with an enlarged-calcified galbladder with liquid non-air content. retroperitoneal space shows a diffusely growth, I can see some adenomegaly (non contrast-enhanced) and the principal arteries an veins. kidney pelvis is unusual because of an enhanced mass less than 1 cm. I can see too multiple small lessions (less than 1 cm) in the spleen. Probably I would ask for a CA19-9 antigen, extend the CT to the chest and take a biopsy of the mass next to chest wall, thinking on a bile duct/gall bladder carcinoma, extended disease. There is not free fluid in peritoneum. Vertebra looks like it could have al lytic lession, but i'm not sure.

     
  26. Anonymous Says:
  27. parceline GB with cholecystitis

     

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