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Cholecystitis (emphysematous)

Authoring team

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

Reference:

  1. Miyahara H, Shida D, Matsunaga H, Takahama Y, Miyamoto S. Emphysematous cholecystitis with massive gas in the abdominal cavity. World J Gastroenterol. 2013 Jan 28;19(4):604-6. doi: 10.3748/wjg.v19.i4.604. PMID: 23382645; PMCID: PMC3558590.

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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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