Abstract
Two cases of emphysematous cholecystitis are reported. The first patient was a 70-year-old male farmer who was first diagnosed to have upper gastrointestinal bleeding. As the patient's abdominal roentgenogram showed a rounded radiolucency and internal air-fluid collection in the right subcostal region, an impression of emphysematous cholectitis was obtained, and mild abdominal pain in the corresponding area was found to have been present for two days. The patient was operated upon after improvement of his general condition, and the postoperative course was smooth. The second patient, a 73-year-old male farmer, was admitted with severe right upper abdominal pain and high fever, and the same diagnosis was made with a plain abdominal roentgenogram, supported by computed tomographic findings. An emergency cholecystectomy was performed, and the patient also made a smooth recovery. The pathogenesis, causative agents, diagnosis and treatment of emphysematous cholecystitis are discussed. It is concluded that this disease should be detected early and treated adequately with proper antibiotics, and often with prompt surgery in acute or emergency cases.
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