case_images: PMC3628491_01
case_images: Twenty-four hours Indium-111 WBC gallbladder scan reveals increased accumulation of 111 in-leukocytes within the gallbladder wall suggestive of hyperemia/inflammatory changes in the pericholecystic region (arrow) (donut sign).
case_images: CRIM.MEDICINE2013-418014.001.jpg
case_images: PMC3628491_01_CRIM.MEDICINE2013-418014.001.jpg
case_images: fig1
case_images: Three days later, further testing to identify the cause of leukocytosis and source of infection included Indium WBC whole-body scan which showed increased accumulation of 111 in-leukocytes within the gallbladder wall suggestive of hyperemia/inflammatory changes in the pericholecystic region (Figure 1).
case_images: Computed tomography of the abdomen with oral contrast showing the gallbladder markedly distended (long arrow). Air bubbles project over the region of gallbladder neck are seen, suggestive of infection with gas-producing organism (short arrows).
case_images: CRIM.MEDICINE2013-418014.002.jpg
case_images: PMC3628491_01_CRIM.MEDICINE2013-418014.002.jpg
case_images: fig2
case_images: Finally, CT scan of the abdomen showed a distended gallbladder with air bubbles project at the region of the gallbladder neck suggestive of an infection with gas-producing organisms and complicated cholecystitis (Figure 2).