Emphysematous cholecystitis

Case contributed by Dr Aneta Kecler-Pietrzyk

Presentation

Severe epigastric pain radiating to the back. High serum CRP and lactate. Background of type 2 diabetes.

Patient Data

Age: 50 years
Gender: Female
X-ray

Rounded lucency in the right upper quadrant likely representing dilated gallbladder. 

Serpiginous lucent structure is also seen superiorly to gallbladder which is non specific but may represent air within biliary tree. 

See annotated images. 

X-ray

Rounded lucency (white arrows) in the right upper quadrant likely representing dilated gallbladder. 

Serpiginous lucent structure (black arrows) also seen superior to gallbladder which is non-specific but may represent air within the biliary tree. 

CT

The gallbladder is distended and there is air identified within its wall. Air also seen in the intrahepatic biliary ducts and common bile duct.

Cholelithiasis and mild pericholecystic fat stranding are also observed.

Additionally multiple low attenuation areas within the liver and both kidneys in keeping with infarcts.

The bowel is of normal calibre. No pneumatosis. 

Foley catheter in situ.

Case Discussion

 Features consistent with emphysematous cholecystitis.

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Case information

rID: 54425
Case created: 9th Jul 2017
Last edited: 11th Nov 2017
Inclusion in quiz mode: Excluded

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