Emphysematous cholecystitis. Diagnosis, clinical course, and treatment
Madriñán González, M.; Fraguela Mariña, J.; Acea Nebril, B.; Taboada Filgueira, L.; Blanco Freire, M.N.; Fernández Blanco, C.; Aguirrezabalaga, G.J.; Rosales Juega, D.; Rey Simó, I.; Gómez Freijoso, C.
Revista Espanola de Enfermedades Digestivas Organo Oficial de la Sociedad Espanola de Patologia Digestiva 91(12): 853-856
1999
ISSN/ISBN: 1130-0108 PMID: 10619915 Document Number: 499474
Emphysematous cholecystitis is the most severe acute cholecystitis with infection by gas-producing organism. The morbidity and mortality rate are 15%. We present a retrospective study of emphysematous cholecystitis seen in our department during three years (1992-1994). Inclusion criteria were made on the basis of a characteristic history, physical examination and radiology findings. Eight patients were studied. All were men, medium age 75 years (range: 45-88). None of them was diabetic. Clinical history was typical for the disease. Radiological examinations included abdominal X-ray (none of them was demonstrative), abdominal ultrasound (carry out in five patients and diagnosis in two) and computerised tomography scanning was necessary in the others three patients. Surgery was required since complication occurred in two patients. The mean duration until surgery was 5.21 day. Only three patients had any postoperative complication and nobody death. We concluded that the treatment of choice is cholecystectomia, except for high risk patient in whom puncheon and drainage is required.