Point-of-care Ultrasound Diagnosis of Emphysematous Cholecystitis

Hammadi, Fadwa Al; Buhumaid, Rasha

doi:10.5811/cpcem.2019.11.45337

Cited by 5 publications

(7 citation statements)

References 5 publications

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“…The reason behind the presence of air is bile infected with gas-producing bacteria (Clostridium species, Fusobacterium nucleatum, Escherichia coli, Klebsiella species, and anaerobic streptococci) [4,5]. According to the reports, the ischemia of the gall bladder is the main contributing factor for secondary infection occurrence with gas producing bacteria [6]. The gross pathology presents with gall bladder necrosis as seen in this case report.…”

Section: Discussionmentioning

confidence: 64%

Emphysematous Calculous Cholecystitis Diagnosed with Abdominal CT in a Diabetic Female Patient – Case Report

Misimi,

Aliu,

Kanevce

et al. 2023

Prilozi

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Emphysematous cholecystitis is reported to have a low incidence of less than 1% in all cases of acute cholecystitis and yet a high mortality rate of up to 15%. It is most commonly seen in male diabetic patients with advanced age. The diagnosis is established with the presence of gas in the gallbladder lumen and/or within its wall which can be seen on plain abdominal radiography, abdominal ultrasound, and abdominal computerized tomography. The clinical presentation refers to one of acute cholecystitis, but the treatment requires prompt cholecystectomy since the patient’s condition can deteriorate due to the possibility of gallbladder perforation. We present a case of a 71-year-old female diabetic patient with calculous emphysematous cholecystitis treated with emergency open cholecystectomy.

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Section: Discussionmentioning

confidence: 64%

Emphysematous Calculous Cholecystitis Diagnosed with Abdominal CT in a Diabetic Female Patient – Case Report

Misimi,

Aliu,

Kanevce

et al. 2023

Prilozi

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“…Abdominal ultrasound is often used as the initial imaging for detecting gallbladder disease and can be used to diagnose emphysematous cholecystitis. On ultrasound, gas may be detected in the gallbladder lumen, wall, or pericholecystic tissue and can be used to stage emphysematous cholecystitis [ 1 , 3 , 9 - 10 ]. In addition, emphysematous cholecystitis may present as an effervescent gallbladder on ultrasound with the appearance of multiple bubbles in the lumen or curvilinear gaseous artifacts known as the “ringdown effect” [ 1 , 3 , 9 - 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…On ultrasound, gas may be detected in the gallbladder lumen, wall, or pericholecystic tissue and can be used to stage emphysematous cholecystitis [ 1 , 3 , 9 - 10 ]. In addition, emphysematous cholecystitis may present as an effervescent gallbladder on ultrasound with the appearance of multiple bubbles in the lumen or curvilinear gaseous artifacts known as the “ringdown effect” [ 1 , 3 , 9 - 10 ]. Both are diagnostic for emphysematous cholecystitis but may not be present in all cases.…”

Section: Discussionmentioning

confidence: 99%

“…The most sensitive and specific imaging tool for emphysematous cholecystitis is computerized tomography [ 3 , 10 ]. Computerized tomography revealing gas in the biliary tree is diagnostic for emphysematous cholecystitis and can provide further information on the location and extent of air collection determining the best options for intervention [ 3 , 9 - 10 ].…”

Section: Discussionmentioning

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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“…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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Point-of-care Ultrasound Diagnosis of Emphysematous Cholecystitis

Cited by 5 publications

References 5 publications

Emphysematous Calculous Cholecystitis Diagnosed with Abdominal CT in a Diabetic Female Patient – Case Report

Emphysematous Calculous Cholecystitis Diagnosed with Abdominal CT in a Diabetic Female Patient – Case Report

Perforated Emphysematous Cholecystitis: A Race Against Time

Emphysematous Cholecystitis Secondary to Fusobacterium nucleatum

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