case_images: PMC5971341_01
case_images: Coronal MRI image demonstrating large gallbladder empyema (a), and transverse MRI image section demonstrating 12 mm obstructing gallstone in the cystic duct (b).
case_images: CRIS2018-1609601.001.jpg
case_images: PMC5971341_01_CRIS2018-1609601.001.jpg
case_images: fig1
case_images: Her white cell count was elevated, and a magnetic resonance cholangiopancreatography (MRCP) revealed an empyema of the gallbladder (Figure 1). There was an obstructing calculus in the cystic duct (Figure 1); however, the biliary tree was nondilated.
case_images: Fluoroscopy-guided insertion of a collapsed 6 mm x 60 mm bare metal stent into the cystic duct prior to deployment (a). Note the round filling defects, consistent with gallbladder calculi (arrows). Subsequent successful deployment of a 6 mm x 60 mm bare metal stent in the cystic duct, and an 8 mm x 100 mm bare metal stent in the common bile duct and duodenum, with antegrade contrast clearance (b).
case_images: CRIS2018-1609601.002.jpg
case_images: PMC5971341_01_CRIS2018-1609601.002.jpg
case_images: fig2
case_images: A 6 mm x 60 mm bare metal stent was inserted into the cystic duct (Figure 2), and an 8 mm x 100 mm bare metal stent was inserted from the mid-cystic duct through the ampulla of Vater into the duodenum. Rapid antegrade clearance of contrast from the gallbladder was then demonstrated on cholecystogram (Figure 2).
case_images: CT scan two days after stent insertion demonstrating appropriate positioning and relative size of the bare metal stents in the cystic and common bile ducts.
case_images: CRIS2018-1609601.003.jpg
case_images: PMC5971341_01_CRIS2018-1609601.003.jpg
case_images: fig3
case_images: A CT scan confirmed appropriate positioning and sizing of the metallic stents (Figure 3) and revealed a collapsed gallbladder with no discrete collection.