title: Patient with perforation caused by emphysematous cholecystitis who showed flare on the skin of the right dorsal lumbar region and intraperitoneal free gas.
abstract: We report an 84-year-old man with perforation caused by emphysematous cholecystitis who showed flare on the skin of the right dorsal lumbar region and intraperitoneal free gas. The patient was admitted for abdominal pain, abdominal swelling, and consciousness disorder 18 days after the onset. Abdominal computed tomography (CT) revealed emphysema in the gallbladder and a small amount of intraperitoneal free gas. Intraoperative findings suggested gangrenous cholecystitis. The gallbladder wall was perforated, and an abscess involving the right subphrenic region, the periphery of the liver and gallbladder, and the right paracolonic groove, was detected. The flare on the body surface may have reflected abscess formation in the right abdominal cavity. Emphysematous cholecystitis induces necrosis and perforation in many patients, and immediate strategies such as emergency surgery are important.
authors.affiliation: Department of Surgery, Hiroshima City Funairi Hospital, 14-11 Funairisaiwai-cho, Naka-ku, Hiroshima 730-0844, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kanehiro
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Tsumura
authors.forename: Toru
authors.initials: T
authors.lastname: Ichikawa
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hino
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Murakami
authors.forename: Taijiro
authors.initials: T
authors.lastname: Sueda
mesh_terms: D000005:Abdomen; D000369:Aged, 80 and over; D041882:Emphysematous Cholecystitis / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D004890:Erythema / Q000209:etiology*; D005704:Gallbladder / Q000473:pathology*; D005734:Gangrene; D006801:Humans; D008297:Male; D011027:Pneumoperitoneum / Q000209:etiology*; D012422:Rupture, Spontaneous; D014057:Tomography, X-Ray Computed