65 year-old diabetic patient presents with abdominal pain. What's the abnormality on Xray?
Answer
Emphysematous Cholecystitis
Emphysematous Cholecystitis
More common in elderly patients, especially with diabetes
Usually due to ischemia secondary to systemic hypoperfusion, atherosclerosis, embolism, or vasculitis
Common organisms causing infection include Clostridium, E. Coli, Klebsiella, and anaerobic streptococci.
Early antibiotic treatment is mandatory, but definitive surgery is typically required
Air-fluid level and distended gallbladder may be seen on upright plain abdominal radiographs; CT scan demonstrates air in the GB wall and sometimes throughout the biliary tree
References
Carrascosa MF, et al. Emphysematous Cholecystitis. CMAJ.10 Jan 2012; 184(1): E81
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