This patient is a 77-year-old with history of polymyalgia rheumatica who presents with an episode of abdominal pain. Of note, the patient is taking steroids to treat his polymyalgia rheumatica. His abdominal pain began one day prior to admission in his left upper back and migrated to the left flank. The patient presented to the Emergency Room complaining of left flank pain when his pain became severe. During the course of the Emergency Room stay, the patient's pain further migrated to the left chest and epigastrium and eventually settled in the right upper quadrant.

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A focus near the hilum of the liver appears by 15 minutes post injection and persists throughout the study. The focus does not correspond to the location of the gall bladder and more likely represents a dilated cystic duct.

Non-visualization of the gallbladder concerning for acute cholecystitis.