Female with right upper abdominal pain.
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Emphysematous cholecystitis is a form of acute cholecystitis caused by gas-forming infection in gallbladder (GB) lumen, wall, or both. Although this condition develops in approximately 1% of all cases of acute cholecystitis, compared with typical acute cholecystitis, emphysematous cholecystitis is associated with much higher rates of gangrene and perforation of the gallbladder and significantly increased rates of mortality.
Most common signs and symptoms are fever, right upper abdominal pain and sepsis. Older males are more common affected and it has a close association with diabetes.
The best diagnostic clue is the finding of intramural or intraluminal gas within GB. Gas in GB wall seen at ultrasonography results in highly echogenic reflections, casting "dirty shadowïng".
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