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Figure it out fridays 

#64

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26 year-old man with no past medical history, was admitted to the emergency department for cramped abdominal pain in the right hypochondrium associated with vomiting that was more severe after eating. This pain had been present for 24 h and was of increasing intensity. There was no fever neither jaundice. Vital parameters were normal.

The abdominal exam showed tenderness in the right upper quadrant.

Laboratory tests showed white blood cells at 14470/mm3, a C-reactive protein at 3 mg/L, a creatinine at 67umol/l with no alteration of the liver; pancreatic tests, and ionogram.

Ultrasound and CT done as shown above. 

The decision was made to take the patient for a diagnostic laparoscopy, intra-op findings shown.

Based on the history and images above, what is the most likely diagnosis?

A. Carcinoma

B. Acute cholecystitis

C. Chronic cholecystitis

D. Gallbladder torsion

E. Gallbladder Mucocele (Hydrops) 

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