In retrospect, reexamination of the gallbladder on the CT scan shows a faint line demarcating the mucosa, and the thickened wall. The final diagnosis was acalculous cholecystitis with gangrene and pylephlebitis.
Surgical Chief Resident: Leonard Henry
Discussion:
Given this patient's minimal clinical findings, it was fortuitous that the CT reading was interpreted as pneumatosis coli. The early operative intervention revealed the true problem and avoided delay that might have occurred if the decision were based on the benign clinical picture.
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