title: Emphysematous cholecystitis due to Clostridium perfringens successfully treated by cholecystectomy.
abstract: Emphysematous Cholecystitis is life threatening if left untreated. It is associated with arteriosclerosis, embolic events, and diabetes mellitus. In this report, a patient was presented with an early diagnosis of Emphysematous Cholecystitis and was treated by cholecystectomy without complications. A 46-year-old male presented at the emergency department. Laboratory results as well as the abdominal ultrasound showed no abnormalities. One day after admission, infection parameters started rising. A computed tomography (CT) showed cholecystitis with a circular gas pattern in bile ducts and gallbladder. After treatment with cholecystectomy and antibiotics, the patient recovered uneventfully. The gallbladder mucosa was denaturized with signs of necrosis. The bile culture was positive for Clostridium perfringens. Treatment was based on preoperative antibiotic treatment combined with cholecystectomy. This resulted in early clinical improvement of the patient and normalization of infection parameters. Therefore, the patient was discharged from the hospital four days postoperatively.
authors.affiliation: a Department of Surgery , Laurentius Hospital, Roermond , The Netherlands.
authors.forename: Simone Nienke
authors.initials: SN
authors.lastname: Koole
authors.affiliation: a Department of Surgery , Laurentius Hospital, Roermond , The Netherlands.
authors.forename: Bjorn Gerardus Petrus Maria
authors.initials: BG
authors.lastname: Lohman
authors.affiliation: a Department of Surgery , Laurentius Hospital, Roermond , The Netherlands.
authors.forename: Josephus Marinus Jacobus
authors.initials: JM
authors.lastname: van Unen
mesh_terms: D000006:Abdomen, Acute / Q000175:diagnosis / Q000209:etiology; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001707:Biopsy, Needle; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D003015:Clostridium Infections / Q000175:diagnosis / Q000628:therapy; D003016:Clostridium perfringens / Q000302:isolation & purification*; D004636:Emergency Service, Hospital; D041882:Emphysematous Cholecystitis / Q000175:diagnosis* / Q000382:microbiology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: Cholecystectomy; Clostridium perfringens; emphysematous cholecystitis