Emphysematous cholecystitis is an uncommon condition which may mimic acute cholecystitis. But it differs from acute cholecystitis in its relatively greater frequency in men and diabetics and has graver prognosis. The condition is diagnosed by demonstration of air in lumen,wall of gallbladder and/or pericholecystic space using a variety of radiographic techniques: simple abdominal radiography, ultrasonography and CT scanning. One illustrative case is presented herein and the pertinent literature is reviewed.
Cholecystitis, Acute ; Emphysematous Cholecystitis* ; Gallbladder ; Humans ; Male ; Prognosis ; Radiography, Abdominal ; Tomography, X-Ray Computed ; Ultrasonography

Emphysematous cholecystitis is an uncommon form of acute cholecystitis characterized by the presence of gas within the wall, lumen of the gall bladder or biliary ducts. Clinically it is very similar to ordinary farm. But since the risk of perforation is five times that expected from ordinary cholecystitis, early diagnosis and appropriate surgical treatment are important. We could diagnose these cases by the simple abdomen, abdominal ultrasound and abdominal CT by the presence of air in the lumen and the wall of the gall bladder. Percutaneous trans hepatic gall bladder drainage (PTGBD) for decompression was used because poor general condition of patients and later, we could successfully perform the cholecystectomy without any complication. We presented two cases of emphysematous cholecystitis with review of the relevant literature on the subject.
Abdomen ; Cholecystectomy ; Cholecystitis ; Cholecystitis, Acute ; Decompression ; Drainage ; Early Diagnosis ; Emphysematous Cholecystitis* ; Humans ; Tomography, X-Ray Computed ; Ultrasonography ; Urinary Bladder

Transarterial chemoembolization (TACE) is reportedly a useful palliative treatment in patients with unresectable or recurred hepatocellular carcinoma. Post-TACE complications are common; however, acute cholecystitis after TACE is rare. We herein report a case of a 73-year-old woman who presented with emphysematous cholecystitis and pneumobilia following TACE. Computed tomography performed for evaluation of her tumor status before TACE incidentally showed gallbladder and common bile duct stones. After TACE, she complained of severe epigastric pain with a positive Murphy's sign. Computed tomography showed emphysematous cholecystitis and pneumobilia. She was successfully treated with emergent biliary stone removal by endoscopic retrograde cholangiopancreatography.
Aged ; Carcinoma, Hepatocellular ; Chemoembolization, Therapeutic ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystitis, Acute ; Common Bile Duct ; Emphysematous Cholecystitis ; Female ; Gallbladder ; Humans ; Palliative Care

Emphysematous cholecystitis is an uncommon but life-threatening form of acute cholecystitis that is caused by gas- forming organisms such as Clostridia species, Escherichia coli, Klebsiella, and anaerobic streptococci. Emphysematous cholecystitis frequently affects elderly men, and is associated with diabetes mellitus. The risk of gangrene and perforation of the gallbladder is relatively high in emphysematous cholecystitis patients, and there is a 15% mortality compared with the 4% for acute cholecystitis. We report here a case of emphysematous cholecystitis in a 56-year-old woman, who had diabetes for 10 months. The patient presented with right upper abdominal pain and chills. The abdominal plain film showed a mottled gas pattern in the right upper quadrant. The laboratory value revealed massive intravascular hemolysis. The patient deteriorated rapidly during the course of the evaluation and required cardiopulmonary resuscitation. Despite the attempts to resuscitate the patient, she died 9 hours after the onset of symptoms.
Abdominal Pain ; Aged ; Cardiopulmonary Resuscitation ; Chills ; Cholecystitis, Acute ; Diabetes Mellitus ; Emphysematous Cholecystitis* ; Escherichia coli ; Female ; Gallbladder ; Gangrene ; Hemolysis ; Humans ; Klebsiella ; Male ; Middle Aged ; Mortality ; Sepsis*

Acalculous hemorrhagic cholecystitis is a rare complication of acute cholecystitis and is associated with a high mortality rate. We present a case of acalculous hemorrhagic cholecystitis with hematoma in the gallbladder lumen, which was diagnosed using magnetic resonance imaging (MRI). The T1- & T2-weighted MRI revealed gallbladder distension with a hypointense intraluminal hematoma. The excellent tissue contrast provided by MRI is useful for detecting hematomas in the cases of hemorrhagic cholecystitis.
Acalculous Cholecystitis ; Cholecystitis ; Cholecystitis, Acute ; Gallbladder ; Hematoma ; Magnetic Resonance Imaging

No abstract available.
Cholecystitis, Acute ; Constriction, Pathologic ; Stents

Limy bile is a relatively rare condition in which a radiopaque material is visible in the gallbladder, extending rarely into the bile duct, on plain radiography. Acute cholangitis or cholecystitis caused by limy bile is a very rare condition. There are no definite treatment guidelines for limy bile, but in most cases with cholangitis or cholecystitis, laparoscopic cholecystectomy has been the preferred treatment. We report a case of limy bile with biliary symptoms that was treated only with an endoscopic procedure.
Bile ; Bile Ducts ; Cholangitis ; Cholecystectomy, Laparoscopic ; Cholecystitis ; Cholecystitis, Acute ; Gallbladder

To assess the pathological basis of the sonographic changes of the gallbladder wall in cholecystitis, thesonographic appearances of the gallbladder wall were analysed in 17 patients with acute cholecystitis and 27patients with chronic cholecystitis, and correlated with pathological specimens removed at surgery. In acutecholecystitis, a thin sonolucent layer within the echogenic gallbladder wall corresponds to subserosal edema,hemorrhage and inflammatory cell infiltration: in chronic cholecystitis it corresponds to subserosal edema,hemorrhage and inflammatory cell infiltration: in chronic cholelcystitis it corresponds to subserosal edema,hemorrhage and inflammatory cell infiltration, in chronic cholelcystitis it corresponds to muscular hypertrophy.Indistinctness and/or a low echogenicity rind along the inner margin reflects mucosal sloughing or obliteration ofthe mucosal folds. Uniformly decreased echogenicity of the wall is caused by severe inflammatory cell infiltrationwith sloughing of the mucosa or obliteration of the mucosal folds. These sonographic singns are considered to bevaluable sings of cholecystitis.
Cholecystitis ; Cholecystitis, Acute ; Gallbladder ; Humans ; Mucous Membrane ; Ultrasonography

Gangrenous cholecystitis is a kind of acute cholecystitis, whose course of disease progresses rapidly, early diagnosis is difficult and mortality is high, and clinicians are prone to misdiagnosis and missed diagnosis in clinical work.However, gangrenous cholecystitis has been ignored in various guidelines.This paper systematically summarized the pathogenesis, pathological manifestations, epidemiology, clinical diagnosis and treatment of gangrenous cholecystitis, hoping to provide a complete and clear diagnosis and treatment process for clinicians.
Cholecystectomy ; Cholecystitis/surgery* ; Cholecystitis, Acute/surgery* ; Gangrene/surgery* ; Humans

Perforation of gallbladder is a serious complication of acute cholecystitis with alarmingly high mortality rate. These high mortality and morbidity rates were caused by delay in prompt diagnosis and adequate therapy. Especially, mortality and morbidity rates rise markedly in the elderly patient with severe systemic illness. In the patients of gallbladder perforation who are poor candidate for general anesthesia and major operation, percutaneous cholecystic drainage procedure is good alternatives. We experienced a case of gallbladder perforation which was treated successfully by non-operative percutaneous transhepatic cholecystic drainage(PTCCD) in 65-year-old female. She couldn't be a candidate for cholecystectomy or operative chlecystostomy because of severe adhesion of gallbladder to adjacent organ and tissue due to previous gallbladder empyema. We decided to take non-operative percutaneous transhepatic cholecystic drainage and percutaneous peritoneal drainage of abdominal abscess. Thereafter, we examined gallbladder by percutaneous transhepatic cholecystoscopylPTCCS)and rule out gallstone and gallbladder malignancy. So, we presented the case with the brief review of the literatures.
Abdominal Abscess ; Aged ; Anesthesia, General ; Cholecystectomy ; Cholecystitis ; Cholecystitis, Acute ; Diagnosis ; Drainage* ; Female ; Gallbladder* ; Gallstones ; Humans ; Mortality