Acute Emphysematous Cholecystitis

Abstract

Emphysematous cholecystitis is a rare but life-threatening condition. The initial clinical manifestations of the disease may be insidious, but rapid progression to sepsis may occur despite aggressive therapeutic intervention, so early diagnosis and treatment are important to prevent the catastrophic septic consequences. Conventional radiography and abdominal sonography are often the initial imaging modalities used for evaluation. Characteristic gas around the gallbladder fossa is imperative for a diagnosis of emphysematous cholecystitis. If the differential diagnosis remains or further evaluation of the severity or localization of the disease is needed, computed tomography should be considered. Knowledge of the common predisposing conditions such as diabetes and gallstones, the pathophysiologic characteristics, and typical imaging features will greatly favor a correct diagnosis and make successful treatment possible. We report on a 51-year-old male patient who complained of severe right upper quadrant pain. The clinical course, examinations, and treatment are discussed along with a review of the literature.