-
Gallbladder empyema (suppurative cholecystitis) is an uncommon complication of gallstone disease. This is due to complications of acute persistent infection of the gallbladder. In empyema, the gallbladder lumen is filled by purulent material. Here we discuss a case of undiagnosed diabetes leading to this serious complication. Patients should not wait
Gallstones and diseases of the gallbladder are one of the most common diseases that affect the general population. Symptomatic gallstones usually present with dull aching pain, nausea, dyspepsia, and fatty food intolerance. However, it is common to see patients ignoring these symptoms and suffer from these persistent symptoms. Some patients progress to have persistent pain and unable to eat even normal food. Some develop complications of the gallstones which include an acute infection, common duct stone, cholangitis and sometimes moderate to severe pancreatitis.
Ultrasound
Ultrasound may show the usual sonographic features of cholecystitis with added echogenic content within the gallbladder lumen (this feature is however not specific for an empyema). In cases of extensive calculous cholecystitis where gallstones fill the galbladder lumen it may be difficult to assess the echogenicity of bile and further cross-sectional imaging may be required.
CT
CT may show general imaging features of cholecystitis with added high-attenuating material (representing pus) within the distended gallbladder lumen. Again this feature is nonspecific and is often difficult to differentiate from sludge within the gallbladder.