Radiological Case: Acute Perforated Acalculous Cholecystitis

Suraj Parekh, MD; Sherif Andrawes, MD; Christopher Giordano, MD; Richa Sharma, MD


Appl Radiol. 2018;47(2):20-23. 

In This Article


While acute cholecystitis is not an uncommon entity for which the diagnosis is usually made promptly, gallbladder perforation resulting from prolonged obstruction of the cystic duct is rarely seen. It is, however, more commonly seen (although still relatively rare) in cases of acute acalculous cholecystitis. It is critical to recognize the radiographic signs, such as a discontinuous gallbladder wall, which would suggest a perforated gallbladder so that patient care can be expedited. This is especially important as the morbidity and mortality associated with perforated gangrenous cholecystitis is much higher than its non-perforated precursor.