An additional finding indicative of an acute inflammation is pericholecystic accumulation of f1 uid (68). In some cases , the accumulated fluid can be confined to Morison's pouch between the inferior hepatic border and the right kidney. Finally, the gallbladder outline can become indistinct along the hepatic parenchyma (9). A transverse diameter of the gallbladder of more than 4 cm indicates a hydrops, but even more characteristic is the change from a typical pear shape to an apple shape due to biconvex and spherical expansion of the gallbladder