Figure 1

Diagnostic, intra-operative and histological images. Ultrasound images of (A) his gallbladder showing a thickened wall but no gallstones and (B) of his right iliac fossa, without evidence of free fluid and without visualization of his appendix. Intra-operative laparoscopy images demonstrating (C) a necrotic gallbladder and (D) acute appendicitis. Histological images demonstrating (E) gallbladder mucosa with acute inflammation with necrosis of the mucosa and submucosal thrombi and (F) acute appendicitis.