A 23-year-old man with hepatitis C was admitted for a liver biopsy. The next day persistent, localized, right-upper-quadrant pain developed, as well as a mild fever. Abdominal ultrasonography 5 days after the biopsy showed a normal gallbladder wall without evidence of inflammation or pericholecystic fluid. Within the gall bladder was a heterogeneous ldquo;cast.rdquo; Morphine enhanced cholescintigraphy performed on the same day showed neither visualization of the gallbladder nor a biliary leak. A cholecystectomy was performed because of the persistent symptoms. Omentum surrounded the gallbladder, isolating it from the abdominal cavity. The resected gallbladder contained sludge and clotted blood. A puncture site was found at the fundus.
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