An ultrasound demonstrates gall stones, a thickened gall bladder wall and a pericholecystic fluid collection all consistent with acute cholecystitis. Her common bile duct is 8 mm without stones. Her LFT's are normal except an alkaline phosphatase of 187. Don't Know 2. Laparoscopic cholecystectomy is performed.
Acute cholecystitis is found with a markedly edematous dilated gall bladder.
Intraoperative cholangiogram is attempted but is unsuccessful. The patient is discharged the following day tolerating a regular diet. Three days later she presents in the Emergency Room with nausea, vomiting and epigastric pain. She has a low grade fever, and her LFT's are notable for a total bilirubin of 2.1, alkaline phosphatase of 180, SGOT of 75 and SGPT of 87. She is tender in the epigastrum.