30 year-old male with abdominal pain and diffuse tenderness on exam. Ultrasound is shown, what's the diagnosis?
Answer
Free intra-abdominal fluid.
The patient had ascites in this case, with spontaneous bacterial peritonitis; this was initially thought to be pericholecystic fluid secondary to acute cholecystitis.
Another mimic of acute cholecystitis includes conditions with gallbladder wall thickening such as a contracted GB (e.g, post-prandial) or GB wall edema from fluid overload (e.g., CHF, renal failure, etc.)
