Gangrenous cholecystitis with sloughed, intraluminal membranes on POCUS Worsening RUQ pain/fever. Ill-appearing, low BP. WBC 22.4K. POCUS GB done. Diagnosis? What is going on in the gallbladder? Looks like a gallbladder in a gallbladder on sag image. This is not GB surrounded by ascites. Diagnosis: Gangrenous cholecystitis with sloughed, intraluminal membranes. Pt had stone stuck in cystic duct. GB massively distended: 20 cm sag and 12.7 cm transverse. Inner mucosal layer has sloughed off completely but maintained integrity within the GB. Life threatening condition. US Murphy's sign is negative generally. Requires urgent surgery. Ultimately was discharged after surgery and long hospitalization to SNF. - Dr. Robert Jones @RJonesSonoEM #Gangrenous #cholecystitis #POCUS #clinical #ultrasound #RUQ #gallbladder #distended #membranes
