Emphysematous Cholecystitis

Abstract

Emphysematous cholecystitis (EC) is a rare but deadly variant of acute cholecystitis noted by the presence of gas in the gallbladder lumen or wall. This gas, emitted by bacteria, is thought to result from gallbladder ischemia caused by vascular compromise with subsequent bacterial invasion. The two most common bacteria responsible for EC are Clostridia perfringens and Escherichia coli. Symptoms of EC are similar, although often less overt, compared to those of acute cholecystitis (AC). Sonography and radiography are common methods of diagnosing EC, but computed tomography (CT) carries the highest diagnostic accuracy rate. Laparoscopic cholecystectomy is the most common method of treating EC, although conservative therapy and hyperbaric oxygen therapy have also been effective in some cases.