MediAI

  Clinical Hook A 76-year-old man presents to the emergency department with right upper quadrant abdominal pain. At first glance, this sounds like one of the most familiar presentations in abdominal emergency medicine: acute cholecystitis. But the CT tells a more important story. Along the gallbladder wall are small, unmistakably abnormal foci of gas. There is surrounding inflammatory change, and gallstones are present. That tiny amount of gas is not an incidental detail. It changes the diagnosis from an ordinary inflammatory gallbladder disorder to emphysematous cholecystitis , an aggressive infection in which ischemic tissue and gas-producing organisms can combine to produce necrosis, perforation, peritonitis, and sepsis. The key lesson is deceptively simple: When gas is identified around the gallbladder, do not stop at identifying the gas. Determine exactly where it is. Gas confined to the lumen has a different differential diagnosis from gas embedded within the gallbladder wall...

  Acute Cholecystitis on CT: Imaging Biomarkers, AI-Assisted Diagnosis, and Clinical Decision-Making for Emergency Radiology Keywords: Acute Cholecystitis, Gallbladder CT, Emergency Radiology, Medical Imaging AI, Radiology AI, Abdominal CT, Gallstones, CT Interpretation, AI Healthcare, Clinical Decision Support When Right Upper Quadrant Pain Becomes a Surgical Emergency A 56-year-old man presented to the emergency department with sudden-onset severe abdominal pain localized to the right upper quadrant. He reported nausea and progressive discomfort that had worsened over several hours. Physical examination demonstrated marked tenderness over the gallbladder fossa with a positive Murphy sign, while laboratory evaluation revealed inflammatory changes suggestive of an acute infectious process. Contrast-enhanced computed tomography (CT) demonstrated several characteristic imaging findings: Marked gallbladder distension Diffuse gallbladder wall thickening Mucosal hyperenhancement ...