Case 14
History:
65 year old man with a history of diabetes mellitus presenting with right upper quadrant pain
Findings:
Computed tomography scan of the abdomen showed a distended gallbladder with presence of gas within the gallbladder wall. Note was also made of pneumobilia.
Diagnosis:
Discussion:
Emphysematous cholecystitis (EC) is a life-threatening complication of acute cholecystitis characterized by early gangrene and perforation of the gallbladder with a mortality rate of approximately 15 percent. It is the result of bacterial invasion of the gallbladder wall by gas-forming bacteria. The most common micro-organisms implicated are Clostridium species. E coli is also encountered. Vascular compromise of the cystic artery may also play a role in the etiology. EC occurs more often in elderly men.
References:
- Wav LW, Sleisenger MH: Acute cholecystitis. In: Sleisenger MH, Fordtran JS (eds): Gastrointestinal Disease, pp 1379-1380. Philadelphia: W.B. Saunders Company, 1983
