A CT scan confirms, there is air in the gallbladder. He goes to surgery and is found to have a cystic-colonic fistula. This is revised, and he is taken to the ICU. TPN is started for nutritional support. Post-operative day # 1 radiology calls to tell you there is massive air under the right diaphragm. He is stable after surgery.
7. (A) You have him taken back to surgery (B) You tell the radiologist not to worry
His mental status remains poor, he develops a RLL pneumonia and dies. Cultures remain negative, however, biopsy shows adenocarcinoma of the gall bladder.