case_images: PMC5536151_01
case_images: Preoperative ultrasound shows cholelithiasis.
case_images: CRIS2017-8609185.001.jpg
case_images: PMC5536151_01_CRIS2017-8609185.001.jpg
case_images: fig1
case_images: Ultrasound demonstrated a gallstone measuring 1 cm by 3 cm and some fatty liver changes however no evidence of wall thickening, pericholecystic fluid, or ductal dilation (Figure 1).
case_images: Preoperative CT abdomen with cholelithiasis and duodenal wall thickening.
case_images: CRIS2017-8609185.002.jpg
case_images: PMC5536151_01_CRIS2017-8609185.002.jpg
case_images: fig2
case_images: CT abdomen and pelvis with IV contrast demonstrated cholelithiasis as well as thickening of the duodenum and fluid adjacent to the pancreas (Figure 2).
case_images: Preoperative HIDA scan shows normal filling.
case_images: CRIS2017-8609185.003.jpg
case_images: PMC5536151_01_CRIS2017-8609185.003.jpg
case_images: fig3
case_images: HIDA scan was performed that demonstrated normal filling of the gallbladder as well as spillage into the small bowel (Figure 3). However due to continued unremitting abdominal pain and leukocytosis, a laparoscopic cholecystectomy was performed under general anesthesia.
case_images: CT abdomen demonstrating subcapsular collection.
case_images: CRIS2017-8609185.004.jpg
case_images: PMC5536151_01_CRIS2017-8609185.004.jpg
case_images: fig4
case_images: CT abdomen and pelvis with IV and oral contrast revealed a small subhepatic fluid collection unsurprising in light of recent surgery; however there was additionally a new subcapsular fluid collection measuring approximately 15 HU (Figure 4).
case_images: CT guided percutaneous drainage of subcapsular collection.
case_images: CRIS2017-8609185.005.jpg
case_images: PMC5536151_01_CRIS2017-8609185.005.jpg
case_images: fig5
case_images: An 8.5 Fr pigtail drainage catheter was inserted under local anesthesia under CT guidance by interventional radiology (Figure 5).
case_images: Percutaneous pigtail catheter drainage.
case_images: CRIS2017-8609185.006.jpg
case_images: PMC5536151_01_CRIS2017-8609185.006.jpg
case_images: fig6
case_images: Over a liter of bilious fluid was drained upon placement (Figure 6) and 100 cc the following day, which gradually deceased until there was no drainage from the pigtail catheter.