Two Cases of Emphysematous Cholecystitis with Pneumobilia

Kyo Ueki, Dai Ishizuka, Fujio Sugimoto and Mutsuo Saito

Department of Surgery, Kariwagun General Hospital

Case 1: A 55-year-old man seen at the hospital because he had noticed right hypochondralgia had a history of diabetes and hypertension. Computed tomography (CT) showed extensive gas in the lumen of the gallbladder and intrahepatic bile duct. Cholecystectomy conducted on day 1 after adomission revealed 17 bilirubin stones 1 to 3 mm in diameter in the gallbladder. Pathological examination of the gallbladder revealed gangrenous cholecystitis. With cultivation of bile juice collected during operation, a Clostridium was detected. Case 2: A 47-year-old man seen at the hospital due to right abdominal pain had a history of bronchial asthma. CT showed extensive gas in the lumen and wall of the gallbladder and intrahepatic bile duct. Cholecystectomy conducted on day 2 after admission revealed many stones 1 to 5 mm in diameter in the gallbladder. Pathological examination of the gallbladder revealed gangrenous cholecystitis. With cultivation of bile juice collected during operation, a Klebsiella, Aeromonous, Enterococcus and Citrobacter was detected. Our cases are the 21st and 22nd with emphysematous cholecystitis with pnumobilia reported in the Japanese literature.

Key words
emphysematous cholecystitis, pnumobilia

Reprint requests
Kyo Ueki Department of Surgery Kariwagun General Hospital 2-11-3 Kitahannda, Kashiwazaki-shi, Niigata Pref, 945-8535 JAPAN

Accepted
June 26, 2001

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