acute calculus cholecystitis with tiny impacted cystic duct cal, GB perforation with secondary malignant transformation

Markedly distended tensile gallbladder with mild diffuse wall thickening, pericholecystic fat stranding with a tiny impacted cystic duct calculus (partially radio-opaque) – Acute calculous cholecystitis.

An approximately 2.8 x 2.3 cm irregularly marginated thick rim enhancing hypodense intrahepatic collection involving the segment 4B of liver, which is communicating with postero-superior wall of gallbladder – suggestive of concealed gall bladder perforation.

Thick enhancing walls of intrahepatic collection – raises of concern for secondary malignant transformation

A thin perihepatic collection around the gallbladder fundus.

Changes of cystitis with grade I prostatomegaly.

Grade I anterolisthesis of L5 over S1. Status post surgery with bilateral pedicular screws and posterior rods in place at L5,S1 levels with laminectomy