cholecystitis (emphysematous)
Last edited 02/2022 and last reviewed 02/2022
Emphysematous cholecystitis is a rare condition in which bubbles of gas from anaerobic infection appear in the lumen of the gallbladder, its wall, the pericholecystic space, and sometimes the bile ducts.
- Clostridia species, especially C.welchii or Clostridia perfringens, are most often involved, but other gas forming anaerobes such as E. coli or anaerobic streptococci may be found (1).
- Men are affected three times more often than women and 40% of patients have diabetes mellitus (1).
The patient presents with sudden and rapidly progressive right upper quadrant pain, fever and leucocytosis.
- A palpable mass may be felt in the right upper quadrant.
Plain abdominal films reveal gas in the gallbladder lumen and wall and are highly characteristic.
- Rarely, a CT scan may be necessary.
The patient should immediately be given appropriate antibiotics followed by emergency surgery:
- cholecystectomy is preferred
- if the patient is too ill, cholecystostomy may be performed
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