title: Percutaneous drainage of emphysematous cholecystitis associated with pneumoperitoneum.
abstract: Emphysematous cholecystitis, a relatively rare variant of acute cholecystitis, is associated with high morbidity and mortality rates. In the presence of a concomitant pneumoperitoneum, these rates may be considered even higher, approaching those of perforation of the gallbladder. The first choice of treatment in cases presenting with pneumoperitoneum is emergency laparotomy. We performed a staged procedure as a second best alternative. In a 65 year-old female patient, initial percutaneous cholecystostomy with a strict intravenous antibiotics regimen, and subsequent cholecystectomy 6 months, later was carried out with successful outcome. A review of the literature revealed 13 other cases of this combination. Treatment modalities and outcome of these patients are discussed.
authors.affiliation: Department of Hepatobiliary Surgery and Liver Transplantation, University Hospital, Groningen, The Netherlands.
authors.forename: C J
authors.initials: CJ
authors.lastname: Zeebregts
authors.forename: R T
authors.initials: RT
authors.lastname: Wijffels
authors.forename: K P
authors.initials: KP
authors.lastname: de Jong
authors.forename: P M
authors.initials: PM
authors.lastname: Peeters
authors.forename: M J
authors.initials: MJ
authors.lastname: Slooff
mesh_terms: D000208:Acute Disease; D000368:Aged; D002763:Cholecystectomy; D002764:Cholecystitis / Q000000981:diagnostic imaging / Q000601:surgery*; D002767:Cholecystostomy; D004322:Drainage; D004359:Drug Therapy, Combination / Q000008:administration & dosage*; D004630:Emergencies; D004646:Emphysema / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D008795:Metronidazole / Q000008:administration & dosage; D011027:Pneumoperitoneum / Q000000981:diagnostic imaging / Q000601:surgery*; D012086:Reoperation; D014031:Tobramycin / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed
chemical_list: D008795:Metronidazole; D014031:Tobramycin