A Case of Emphysematous Cholecystitis with Pneumobilia

Toru Kamata, Hiroshi Itou, Toru Ii, Masahiro Kanno, Makoto Uogishi, Hiroshi Sodani

Department of Surgery and Gastroenterology, Keiju General Hospital

We present a very rare case of the emphysematous cholecystitis associated with pneumobilia. The patient was a 74-year-old man with chief complaints of right hypochondralgia, fever and jaundice. His past history revealed diabetes mallitus and hypertension. The laboratory examination on admission revealed mild leukopenia, increased CRP, jaundice and liver injury. Abdominal plain film and CT scan showed gas in the wall of the gallbladder and the intrahepatic bile duct. Percutaneous transhepatic gallbladder drainage (PTGBD) was immediately performed. Culture of the bile was positive for K. pneumoniae and Bacteriodies. A cholecystectomy was performed 8 days after admission. Sandlike stones and muddy material were present in the gallbladder. The histopathological findings of the gallbladder showed necrosis. The postoperative course was good. The patient was discharged 16 days after the operation.

Key words
emphysematous cholecystitis, gas of intrahepatic bile duct, percutaneous transhepatic gallbladder drainage

Reprint requests
Toru Kamata Department of Surgery and Gastroenterology, Keiju General Hospital
94 Tomioka-cho, Nanao City, 926 JAPAN

Accepted
April 13, 1994

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