Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
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Case Report

Volume 16, Number 12, December 2025, pages 504-509

Atypical Presentation of Gangrenous Cholecystitis in a Patient With Diabetes Mellitus

Figures

↓  Figure 1. Abdominal ultrasound of the patient displaying thickened gallbladder wall (diameter 4.3 mm, normal < 3 mm) as well as sludge within the gallbladder. Arrow points to sludge within gallbladder.
Figure 1.
↓  Figure 2. Axial computed tomography image displaying gallbladder with evidence of moderate gallbladder wall thickening, inflammatory changes in the surrounding fat, and cholelithiasis. Arrow indicates gallbladder with thickened wall.
Figure 2.
↓  Figure 3. Hepatobiliary iminodiacetic acid study with no uptake of tracer in gallbladder, suggesting cystic duct obstruction.
Figure 3.

Table

↓  Table 1. Key Lab Values Throughout Hospital Course
 
Lab values Hospital day 0 Hospital day 3/day of operation
White blood cell count (reference range 4,000 - 11,000 cells/mL) 10.1 7.6
Glucose (reference range 70 - 100 mg/dL) 307 249
Anion gap (reference range 4 - 12 mEq/L) 19 18
Aspartate aminotransferase (AST) (reference range 8 - 33 U/L) 28 25
Alanine transaminase (ALT) (reference range 4 - 36 U/L) 25 22
Total bilirubin (reference range 0.2 - 1.3 mg/dL) 0.6 0.4