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    Magnetic resonance cholangiopancreatography uncovering massive gallbladder mucocele in a patient with ambiguous clinical and laboratory findings: A case report

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    Author
    Reyes, Q; McLeod, RL; Fernandes, K; Muralidharan, V; Weinberg, L
    Date
    2017-01-01
    Source Title
    International Journal of Surgery Case Reports
    Publisher
    ELSEVIER SCI LTD
    University of Melbourne Author/s
    Weinberg, Laurence; Muralidharan, Vijayaragavan
    Affiliation
    Surgery (Austin & Northern Health)
    Metadata
    Show full item record
    Document Type
    Journal Article
    Citations
    Reyes, Q., McLeod, R. L., Fernandes, K., Muralidharan, V. & Weinberg, L. (2017). Magnetic resonance cholangiopancreatography uncovering massive gallbladder mucocele in a patient with ambiguous clinical and laboratory findings: A case report. INTERNATIONAL JOURNAL OF SURGERY CASE REPORTS, 36, pp.133-135. https://doi.org/10.1016/j.ijscr.2017.04.031.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/256138
    DOI
    10.1016/j.ijscr.2017.04.031
    Abstract
    INTRODUCTION: Radiological imaging of the gallbladder is a fundamental aspect of assessing severity of acute cholecystitis in addition to guiding the optimal timing of surgical intervention. We present a case of acute severe cholecystitis with massive gallbladder mucocele initially presenting with equivocal and inconclusive clinical, laboratory, and ultrasound findings. Magnetic resonance cholangiopancreatography allowed accurate evaluation of cholelithiasis and demonstrated a massive gallbladder mucocele. CASE PRESENTATION: A 39-year-old Caucasian female presented with mild right upper quadrant pain coupled with intermittent epigastric discomfort after meals. Diagnostic abdominal ultrasound could not reliably detect cystic or common bile duct stones due to patient obesity and meteorism. Computed tomography was contraindicated due to severe contrast allergy. Magnetic resonance cholangiopancreatography allowed timely, accurate evaluation of cholelithiasis. This subsequently demonstrated a massive gallbladder mucocele requiring urgent laparoscopic cholecystectomy. CONCLUSION: Magnetic resonance cholangiopancreatography should be considered as a complementary imaging modality to assess patients presenting with atypical biliary symptoms, particularly when ultrasound is equivocal or inconclusive, clinical and laboratory findings are non-specific, and computer tomography is contraindicated. Magnetic resonance cholangiopancreatography can also be considered in patients with acute cholecystitis not adherent to a specific severity grade.

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