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.
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.