Differential Diagnosis for Post-Cholecystectomy Patient

Single Most Likely Diagnosis

• Bile leak or biloma: The presence of edema and small gas bubbles at the gallbladder fossa on CT scan is highly suggestive of a bile leak or biloma, which is a common complication after cholecystectomy.

Other Likely Diagnoses

• Infection or abscess: The edema and gas bubbles could also indicate an infectious process, such as an abscess, at the surgical site.
• Hemorrhage or hematoma: Although less likely, the edema could be due to a hemorrhage or hematoma at the surgical site.
• Colonic injury: The mild thickening of the hepatic flexure of the colon could indicate a colonic injury, which is a possible complication of cholecystectomy.

Do Not Miss Diagnoses

• Bowel perforation: Although the CT scan shows only mild thickening of the colon, a bowel perforation could be life-threatening and should not be missed.
• Hemorrhagic shock: A significant hemorrhage at the surgical site could lead to hemorrhagic shock, which is a medical emergency.
• Sepsis: Any infection or abscess could lead to sepsis, which is a life-threatening condition.

Rare Diagnoses

• Gallbladder bed abscess: An abscess at the gallbladder bed is a rare complication of cholecystectomy.
• Hepatic artery pseudoaneurysm: A pseudoaneurysm of the hepatic artery is a rare but potentially life-threatening complication of cholecystectomy.
• Port site hernia: A hernia at the port site is a rare complication of laparoscopic cholecystectomy.