Acute emphysematous cholecystitis: A case report and review of the world literature

Acute emphysematous cholecystitis is a rare pathological condition of the gallbladder characterized by the growth of gas-producing organisms within a gallbladder, the seat of an acute cholecystitis. The presenting clinical picture is usually indistinguishable from that of an acute cholecystitis. The diagnosis is actually made by roentgen studies of the abdomen which demonstrate a distended gallbladder with air in its lumen and within its wall. The most frequent pathological findings are an acutely inflamed and distended gallbladder containing calculi, usually with gangrenous and suppurative changes, and frequently complicated by a pericholecystic abscess. We may conclude that operation within the first twenty-four to seventy-two hours after onset of symptoms with cholecystectomy, if technically feasible, is the treatment of choice. However, conservative management with the use of large doses of antibiotics has led to satisfactory results in the few patients so treated, and therefore, those that prefer to adopt that method of therapy might be justified in so doing.