A CASE OF ACUTE EMPHYSEMATOUS CHOLECYSTITIS

Abstract

A case of acute emphysematous cholecystitis in a 79-year-old man with underlying diseases of hypertension and diabetes was experienced. The patient was seen at the hospital because of a fever and griping pain with muscular defense in the right hypochondrial region. Severe inflammatory reaction was present. Abdominal imaging methods revealed an air in the gallbladder and around the organ. The patient was diagnosed as acute emphysematous cholecystitis. Though symptomatic remission was obtained by administration of antibiotics, cholecystectomy was carried out because of persisting air. Postoperative course was uneventful, and he was discharged from the hospital on 18th hospital day. In the cultivation of bile juice collected during surgery, the causative microorganism Clostridium was isolated. This disease commonly occurs in aged people who have some arteriosclerotic risk factors such as hypertension and diabetes. It is inferred that tissue gangrene based on arteriosclerotic circulatory impairment in the cystic wall and infection caused by aerogenetic anaerobe might contribute to the mechanisms of the onset of the disease. An increasing tendency of this disease can be expected in a coming aged society, in that this disease should be entertained in terms of acute cholecystitis in aged people.