A Case of Emphysematous Cholecystitis due to Aeromonas Hydrophilia

Haruhiko Nagami, Katsuhiro Tamura*, Akira Nakase*

Department of Surgery, The Second Izumo City Hospital
*First Department of Surgery, Shimane Medical University

A case of emphysematous cholecystitis due to Aeromonas hydrophilia is reported. A 79-year-old woman was admitted to our hospital with mild right hypochondral pain. Abdominal computed tomography (CT) on admission revealed that fundus of the gallbladder was filled with measuring about 3×3 cm in size gallstones and contained a gas shadow. Another abdominal CT, on the 21th hospital day, revealed that the size and location of the gas shadow was unchanged compared with the prior gas shadow. On the 24th hospital day the patient underwent a cholecystectomy and choledochotomy under the diagnosis of emphysemaous cholecystitis with gallstones. Histological examination of the gallbladder revealed gangrenous cholecystitis with multiple ulcers. Aerobic bile and gallstone cultures fielded an oxidase positive, gram negative rod identified as A hydrophilia. Cholecystitis associated with A hydrophilia infection has been noted in three previous cases, but emphysematous cholecystitis due to A hydrophilia has never been reported. Therefore our case is thought to be the first one of this condition.

Key words
emphysematous cholecystitis, Aeromonas hydrophilia

Reprint requests
Haruhiko Nagami Department of Surgery, The Seond Izumo City Hospital
238 Chiimiya-cho, Izumo, 690 JAPAN

Accepted
May 9, 1990

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