Emphysematous cholecystitis: a case report.
A 65-year-old Greek man with a history of diabetes mellitus and hypertension was admitted because of right upper quadrant pain, nausea and palpable right quadrant mass. On admission the patient was febrile (38.8 degrees C) with a total bilirubin level of 1.99 mg/dl (direct 0.59 mg/dl); SGOT 1.26 mg/dl; Na 135 mmol/l and K 2.9 mmol/l. The white blood count was 15200/mul with 92.2% neutrophiles. Axial sections of single slice CT imaging (section thickness 10 mm), revealed emphysematous cholecystitis with thickening of gallbladder wall and wall enhancement after iv contrast enhancement, as well as, dilatation of the gallbladder with multiple gallstones precipitate and intraluminal air. The patient underwent subtotal cholecystectomy and a cholecystostomy was placed. The culture of the bile showed positivity to toxin A of Clostridium Difficile and to Escherichia Coli. The postoperative course of the patient was uneventful.
Papavramidis
Theodossis S
TS
1st Propedeutic Surgical Department, A,H,E,P,A University Hospital, Aristotle's University of Thessaloniki, Thessaloniki, Greece. papavramidis@hotmail.com.
Michalopoulos
Antonis
A
Papadopoulos
Vassilis N
VN
Paramythiotis
Daniel
D
Karadimou
Vassiliki
V
Kokkinakis
Haralambos
H
Fahantidis
Epameinontas
E