57 M well controlled DM& HTN 24-7-18 PAIN UPPER ABD PAIN SEVERE DECUBITUS-- NO PARTICULAR POSTRE GAV RELIEF OF PAIN HIGH FEVER CHILL & RIGOR + VOMITING + RX AT EMERGENCY OF LOCAL HOSP ING DICLOFENAC BLOOD TLC .14 000 LFT NORMAL USG ABD CHOLELITHISIS MRCP -- CHOLEDACOLITHEASIS RX CEFUROXIME PROBIOTICS PLAN -- ERCP REMOVAL CBD STONE THERE AFTER, LAPAROSSCOPIC CHOLECYSTECTOMY.

LikeAnswersShare

Emphysematous GB

Though picture may not be suggesting cholangitis still bile duct clearance of stones and stenting would help Surgeon to go ahead with safe surgery as there is likely cholecystitis or empyema, inflamed GB walls, inflamed calots, intraop bleeding and probably to decrease conversion from Lap approach.

Is the pt on insulin or oha? If on oha start insulin rapid immediately because there are signs of infection then etc and cholecystectomy

Cases that would interest you