Gallbladder imaging: emphysematous cholecystitis: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Gallbladder imaging: emphysematous cholecystitis

Sample item

A diabetic man has severe right upper quadrant pain and sepsis. Ultrasound and CT show gas within the gallbladder lumen and wall. What is the diagnosis and urgency?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Emphysematous cholecystitis, a surgical emergency

Gas-forming organisms such as Clostridium and E. coli infect an ischaemic gallbladder, particularly in diabetics, and cause a high risk of gangrene and perforation. Urgent cholecystectomy or drainage is needed.

Option by option

  • A. Normal pneumobilia after ERCP only

    Pneumobilia is gas within the bile ducts, whereas here gas lies in the gallbladder lumen and wall in a septic patient.

  • B. Porcelain gallbladder

    A porcelain gallbladder shows wall calcification, not gas.

  • C. Gallbladder polyp

    A polyp is a soft tissue projection without gas.

  • D. Emphysematous cholecystitis, a surgical emergency (correct)

    Correct. Gas in the wall or lumen with sepsis is emphysematous cholecystitis.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is D, Emphysematous cholecystitis, a surgical emergency. Gas-forming organisms such as Clostridium and E.

Why is "Normal pneumobilia after ERCP only" not the answer?

Pneumobilia is gas within the bile ducts, whereas here gas lies in the gallbladder lumen and wall in a septic patient.

Why is "Porcelain gallbladder" not the answer?

A porcelain gallbladder shows wall calcification, not gas.

Why is "Gallbladder polyp" not the answer?

A polyp is a soft tissue projection without gas.

What concept does this question test?

It tests Gallbladder imaging: emphysematous cholecystitis in Radiology. coli infect an ischaemic gallbladder, particularly in diabetics, and cause a high risk of gangrene and perforation. Urgent cholecystectomy or drainage is needed.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Gallbladder imaging: emphysematous cholecystitis?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.