Syn: Clostridial Cholecystitis.
cholecystitis is a serious variant of acute cholecystitis,
characterized by the presence of gas in the gallbladder lumen, wall
or pericholecystic tissues in the absence of any abnormal
communication between the biliary system and the gastrointestinal
bacteria is present in the biliary system and the surrounding
of emphysematous cholecystitis is assumed to be ischemia.
cholecystitis is associated with diabetes mellitus and
predominantly affects elderly males usually over 50 years of age.
It has a higher
mortality rate and a more rapid progression than acute cholecystitis,
but has initial clinical findings, similar to those in acute
Gas may be found within
the wall of the gall bladder when secondarily infected by Clostridium
species of the genera
and klebsiella species.
Colonies of microorganisms may be demonstrated on
a gram stain within the necrotic mucosa and within intramural
Gas in the
biliary ducts (pneumobilia) is rarely considered a manifestation of
tomography is extremely valuable in the assessment of suspected
complications of acute cholecystitis, particularly emphysematous
cholecystitis, hemorrhagic cholecystitis, and gallbladder perforation,
which are often very difficult diagnoses to establish at sonography.
considering clinical status, ultrasonographic and radiological
differential diagnosis, adequate and quick preoperative preparation,
cholecystectomy and drainage with appropriate antibiotic treatment and
hyperbaric oxygenation, represent the basic principles in diagnostics
and treatment of this disease.
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