Open AccessEmphysematous cholecystitis with massive gas in the abdominal cavity
Author(s) -
Hiroyuki Miyahara
Publication year - 2013
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.v19.i4.604
Subject(s) - medicine , cholecystitis , ascites , pneumoperitoneum , cholecystectomy , abdominal cavity , perforation , gallbladder , pleural effusion , clostridium perfringens , surgery , abdominal pain , radiology , laparoscopy , materials science , genetics , biology , bacteria , punching , metallurgy
Emphysematous cholecystitis is a rare variant of acute cholecystitis with a high mortality rate. The combination of emphysematous cholecystitis and pneumoperitoneum is also rare. We herein describe a case of emphysematous cholecystitis with massive gas in the abdominal cavity. A 77-year-old male presented with epigastric pain and lassitude lasting for one week. A computed tomography scan demonstrated massive gas in the abdominal cavity. Gas was also detectable inside the gallbladder. Massive ascites as well as a pleural effusion were also detected. Under the diagnosis of perforation of the digestive tract, we performed emergency surgery. Beyond our expectations, the perforation site was not in the alimentary tract, but rather in the gallbladder. We then diagnosed the patient with emphysematous cholecystitis with perforation, and performed cholecystectomy. A pathological examination of the resected gallbladder revealed necrosis in the mucosa and thinning of the wall. Cultures of the ascites detected Clostridium perfringens, a gas-producing microorganism.