Assessing Gallbladder Wall Thickening due to Systemic Venous Congestion Using the VExUS Score With Point-Of-Care Ultrasound.

Gallbladder wall thickening is commonly associated with acute cholecystitis but can also result from systemic venous congestion. Point-of-care ultrasound (POCUS) plays a crucial role in distinguishing between these conditions, especially in critically ill patients. We report the case of a 35-year-old woman with myasthenia gravis and a mediastinal tumor who required mechanical ventilation following tumor resection. During her intensive care unit stay, she developed gallbladder wall thickening indicative of systemic venous congestion, as assessed by POCUS using the Venous Excess Ultrasound (VExUS) score. This finding resolved with diuretic therapy. This case underscores the value of POCUS in differentiating gallbladder wall thickening caused by systemic venous congestion from acute cholecystitis in critically ill patients.