1/3. Concurrent emphysematous pyelonephritis and emphysematous cholecystitis in type 2 diabetes.Concurrence of emphysematous pyelonephritis and emphysematous cholecystitis in a patient with type 2 diabetes has not been reported in the published literature, to the authors' knowledge. A patient who had both at the time of presentation is reported. The mechanism of gas formation and the management strategies are discussed. ( info) |
2/3. A case of emphysematous cholecystitis managed by laparoscopic surgery.BACKGROUND: emphysematous cholecystitis is a rare condition caused by ischemia of the gallbladder wall with secondary gas-producing bacterial proliferation. The pathophysiology and epidemiology of this condition differ from that in gallstone-related acute cholecystitis. This report illustrates a case of emphysematous cholecystitis successfully treated by laparoscopic surgery. methods: An 83-year-old female patient was admitted to the hospital with acute abdominal syndrome. Clinical examination and blood tests suggested acute cholecystitis. Plain radiography revealed a circular gas pattern in the right upper quadrant suggestive of emphysematous cholecystitis. Subsequent computed tomography confirmed the presence of gas in the gallbladder wall and a gas-fluid level within the organ. RESULTS: Emergency laparoscopic cholecystectomy was successfully performed during which bubbling of the gallbladder wall was observed. Intraoperative cholangiography revealed no bile duct stones or biliary obstruction. The patient made an unremarkable recovery from surgery with no postoperative complications or admission to the intensive care unit. Pathological analysis revealed full-thickness infarctive necrosis of the gallbladder. Bacterial cultures grew clostridium perfringens. CONCLUSIONS: This case illustrates a typical case of emphysematous cholecystitis successfully treated by laparoscopic surgery. It contributes to suggestions from other reports that this condition can be safely treated by the laparoscopic approach. ( info) |
3/3. emphysematous cholecystitis due to salmonella derby.We present the case of a woman with diabetes mellitus who developed symptoms and signs consistent with gastroenteritis. After admission for hydration, the patient rapidly became critically ill and an abdominal catastrophe was suspected as the cause of her deterioration. Computed tomography of her abdomen was done and revealed gas in the lumen of the gallbladder consistent with emphysematous cholecystitis. She underwent emergent cholecystectomy, which revealed that the gallbladder had already ruptured. blood cultures grew salmonella derby. After a prolonged hospitalisation she eventually recovered and was discharged home. emphysematous cholecystitis, thought to be a variant of acute cholecystitis, is a medical and surgical emergency. diagnosis relies heavily on imaging findings by ultrasound or computed tomography since the clinical presentation is often non-specific. cholecystectomy remains the treatment of choice in addition to broad spectrum antibiotics and other supportive measures. ( info) |