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Images in Clinical Medicine
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Volume 357:1238 September 20, 2007 Number 12
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Emphysematous Cholecystitis

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A 70-year-old man with a history of heart disease, hyperlipidemia, and diabetes mellitus presented at the hospital with a 4-day history of increasing abdominal pain, nausea, and vomiting. The temperature was 38°C, and examination of the abdomen showed mild tenderness in the right upper quadrant. The white-cell count, including the differential count, showed leukocytosis associated with a left shift. Computed tomography of the abdomen showed multiple small gallstones, pericholecystic fat stranding, an air–liquid level within the gallbladder lumen, and gas dissecting along the entirety of the gallbladder wall — findings consistent with emphysematous cholecystitis. The patient underwent an emergency laparotomy . . . [Full Text of this Article]

 



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