A 58-year-old woman presented with a 2-day history of increasing right-sided abdominal pain. She had no relevant prior history. Examination showed right-sided tenderness and guarding. Temp. was 101 and white blood cell count was 15k with a left shift. Flat plate showed radio-opaque stones in the right upper quadrant. Ultrasound showed an enlarged gallbladder with wall thickening, pericholecystic fluid, stones and a normal size common duct.
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The patient was taken to the operating room for emergency laparoscopic cholecystectomy. Under anesthesia the enlarged gallbladder could be palpated. Upon entering the abdomen through a Hasson umbilical port, there was cloudy free fluid evident.
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