Emphysematous Cholecystitis

Safwan, Mishal; Penny, Steven M.

doi:10.1177/8756479316631535

Cited by 27 publications

(29 citation statements)

References 27 publications

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“…Emphysematous cholecystitis is a fulminant form of acute cholecystitis associated with an increased risk of gallbladder perforation and mortality due to differences in etiology and pathophysiology. While the clinical presentation of emphysematous cholecystitis is nearly indistinguishable from acute cholecystitis, the mortality rate of emphysematous cholecystitis is approximately 15% compared to that of uncomplicated acute cholecystitis at 1.4% [1][2][3], illuminating the importance of prompt diagnosis and intervention.…”

Section: Discussionmentioning

confidence: 99%

“…The causes of an emphysematous gallbladder can range from diabetes, atherosclerotic disease, or infection from bacteria such as Clostridium perfringens, Escherichia coli, and Klebsiella spp. [1][2][3][4]. This case report will further examine the presenting signs and symptoms of a perforated emphysematous gallbladder to correlate future cases of a similar nature.…”

Section: Introductionmentioning

confidence: 99%

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Perforated Emphysematous Cholecystitis: A Race Against Time

Misir¹,

Vahora²,

Unbehaun³

et al. 2023

Cureus

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Emphysematous cholecystitis is a rare infection of the gallbladder that stems from acute cholecystitis. It can rapidly progress and perforate the gallbladder, which would require urgent surgical intervention. A perforated gallbladder can be diagnosed using an abdominal computed tomography by confirming the presence of air in the gallbladder lumen with adjacent extraluminal air. The causes of ruptured emphysematous cholecystitis include, but are not limited to, diabetes, atherosclerotic changes in blood vessels, and infection with Clostridium perfringens, Escherichia coli, and Klebsiella spp., and is usually present in diabetic men. We report on a 57-year-old female who developed gall bladder perforation with an overflow of gallstones into the peritoneum without a history of diabetes or atherosclerotic disease. Due to the vast availability of computerized tomography and early surgical intervention, the rate of mortality due to perforated emphysematous cholecystitis has decreased over the last few decades.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Perforated Emphysematous Cholecystitis: A Race Against Time

Misir¹,

Vahora²,

Unbehaun³

et al. 2023

Cureus

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“…Gas can also form multiple echogenic foci that move from the dependent to the independent area within the lumen of the gallbladder, also known as "effervescent gallbladder" or the "champagne" sign. 4 Computed tomography is more sensitive and specific for the diagnosis of this condition. 5 EC is a surgical emergency that is managed with intravenous antibiotics and cholecystectomy.…”

Section: Discussionmentioning

confidence: 99%

Point-of-care Ultrasound Diagnosis of Emphysematous Cholecystitis

Hammadi

Buhumaid

2020

Clinical Practice and Cases in Emergency Medicine

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A 49-year-old male presented to the emergency department with abdominal pain and generalized weakness. The physical examination was positive for right upper quadrant tenderness and positive Murphy’s sign. Point-of-care biliary ultrasound revealed signs of emphysematous cholecystitis. Emphysematous cholecystitis is a rare biliary pathology with a high mortality rate. It differs from acute cholecystitis is many ways. It has unique ultrasound characteristics. This case highlights the use of point-of-care ultrasound to diagnose a rare biliary condition.

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“…Patients usually present with right upper quadrant pain, fever, nausea, vomiting, and occasionally positive Murphy's sign [5,6]. Ultrasound (US) is the best initial imaging modality for detection, although the ability to visualize EC varies based on the amount of air in the gallbladder.…”

Section: Introductionmentioning

confidence: 99%

“…The most sensitive imaging technique is CT. Diagnosis of EC is based on the clinical presentation and imaging [5,7]. EC is approached as a lifethreatening condition, so patients should be administered antibiotics and undergo a cholecystectomy as soon as possible.…”

Section: Introductionmentioning

confidence: 99%

Emphysematous Cholecystitis Secondary to Fusobacterium nucleatum

Kunadia¹,

Leong²,

Komanduri³

et al. 2021

Cureus

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Fusobacterium nucleatum may be implicated in cases of emphysematous cholecystitis (EC) and carries a high mortality risk, especially in individuals with heart disease, renal insufficiency, and underlying malignancy. Fusobacterium infections are rarely detected in the setting of cholecystitis possibly due to the difficulty with properly culturing the bacteria. We describe a case of a patient with EC in whom blood cultures were positive for growth of F. nucleatum in one of two samples. The patient was treated with empiric antibiotic therapy consisting of metronidazole and cefepime. In patients with EC and negative cultures, it is possible that they may have an undetected infection with fusobacteria, which carries a high mortality risk. As such, clinicians should maintain a high degree of suspicion of obligate anaerobic infection in patients who have negative blood culture for growth in the setting of EC and consider continuation of adequate antimicrobial coverage.

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Emphysematous Cholecystitis

Cited by 27 publications

References 27 publications

Perforated Emphysematous Cholecystitis: A Race Against Time

Perforated Emphysematous Cholecystitis: A Race Against Time

Point-of-care Ultrasound Diagnosis of Emphysematous Cholecystitis

Emphysematous Cholecystitis Secondary to Fusobacterium nucleatum

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