Summary

A 54-year-old man presented with severe right upper quadrant (RUQ) abdominal pain. He denied any infective symptoms. On clinical examination, he was afebrile and anicteric. His abdomen was soft with tenderness elicited on the RUQ. A point-of-care ultrasound in the emergency department demonstrated a distended gallbladder with a thickened wall and an impacted large gallstone at the neck of the gallbladder. Furthermore, the point-of-care ultrasound also identified a highly reflective echo from the anterior surface of the gallstone and marked posterior acoustic shadowing. A diagnosis of cholecysitis was made after confirmatory ultrasonography performed in the radiology department. The patient had a cholecystostomy performed under interventional radiology and was managed with course of intravenous antibiotics for 7 days. He was discharged from hospital with an elective cholecystectomy planned to be performed 8 weeks posthospital discharge.