A middle aged patients present with the complained of right hypochondrial pain. On X-ray, elevated right hemidiaphragm was seen. All of the following are the possible diagnoses except
Ans. b. Acute cholecystitis Causes of Elevated Hemidiaphragm Above the diaphragm Decreased lung volume: Atelectasis/collapse Lobectomy/pneumonectomy Pulmonary hypoplasia Diaphragm Phrenic nerve palsy Diaphragmatic eventration Contralateral CVA:usually MCA distribution Below the Diaphragm Abdominal tumour Subphrenic abscess Liver abscess (Amebic and pyogenic) Radiological findings of Acute Cholecystitis USG findings: Presence of gallstones, thickening of the GB wall (>4 mm), pericholecystic fluid, GB distention USG: IOC for diagnosing acute cholecystitisQ (sensitivity 85%, specificity 95%). HIDA scan: Gold standarddeg for diagnosing acute cholecystitis HIDA scan: No filling of GB with the radiotracer (99mTc-HIDA) after 4 hours indicates an obstructed cystic ductQ
Subphrenic abscess
Acute cholecystitis
Pyogenic liver abscess
Amoebic liver abscess in right lobe