Case Of the Month June 2016
​Contributed By: 
Sivakumar Manickam 
Darent Valley Hospital, Dartford, UK
Clinical History:  78 year old male presented to the Accident and Emergency department with acute onset right upper quadrant pain. Raised CRP. Normal LFTs. Ultrasound in March showed gall stones. ?Calculus Cholecystitis with obstructed biliary tree. Questions: What is the echogenic abnormality within the GB? Why is it vascular on Doppler? Is the CBD obstructed? What is the atypical appearance of the gall bladder due to?

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BIR Case of Week Editors
Prof. N. Kailasanathan, Dr. S. Babupeter, Dr. Iyappan Ponnuswamy