Introduction: Emphysematous cholecystitis or pneumocholecystitis is a condition caused by gas-forming microorganisms that cause ischemia and necrosis of the vesicular wall. It is characterized by the presence of gas in the wall and lumen of the gallbladder. Its incidence is higher in diabetics. It is a rare disease entity responsible for high mortality. However, early diagnosis combined with prompt and appropriate treatment can prevent the progression to septic shock and then death. The objective of this study was to describe the diagnostic and prognostic aspects, in order to enrich the limited literature concerning this pathology. Patients and methods: This was a descriptive retrospective study that ran from January 2019 to December 2021. It concerned patients admitted for emphysematous cholecystitis. Results: We collected 6 records of patients admitted for 6 emphysematous cholecystitis. They accounted for 1.8% of all cholecystectomies (n=278) and 4% of emergency cholecystectomies (n=112). These were 4 men (67%) and 2 women (33%). The mean age was 76.4 years. Patients generally had several histories, including the hypertension-diabetes couple, but 1 patient did not have diabetes. The average consultation time was 3 days. The clinical picture was acute generalized peritonitis in 1 patient and localized irritation to the right hypochondrium in 5 patients with septic shock. The diagnosis in all patients was made by abdominal CT scan. One patient had an ASA IV score, the other 5 patients had a score from ASA to III. In all cases, after intense resuscitation, cholecystectomy was performed, of which four (67%) were performed laparoscopically and 2 (33%) were performed by laparotomy. Bacteriology of bile fluid revealed gram-negative baccilia (E. coli, Citrobacter koseri) and gram-positive cocci (staphylococcus aerus) in 5 cases and 1 case of sterile fluid. The mean length of hospital stay was 5 days (range: 5-18 days). The morbidity was a case of parietal suppuration treated with local dressing. No deaths. Conclusion: Rare pathology. Diagnosis is essentially based on imaging, in this case abdominal CT scans. The prognosis depends on early and appropriate medical-surgical management.
| Published in | Journal of Surgery (Volume 11, Issue 6) |
| DOI | 10.11648/j.js.20231106.13 |
| Page(s) | 136-139 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2023. Published by Science Publishing Group |
Emphysematous Cholecystitis, Abdominal CT Scan, Cholecystectomy, Emergency
| [1] | C. U. Abengowe, P. J. M. McManamon. Acute emphysematous cholecystitis. CMA JOURNAL1974; 111: 1112-4. |
| [2] | Dossouvi Tamegnon, N'Timon Bidamin, Dagbe Massaga, Sorsy Eyram, Adabra Komlan, Elias Césaire et al. Emphysematous cholecystitis: about a case. Emphysematous cholecystitis. MALI MEDICAL 2015; VOLUME 30(2): 53-54. |
| [3] | C. Simon • J. Oliveira • X. Fountain. Biliary peritonitis on emphysematous cholecystitis and Clostridium perfringens hepatic abscess. Ann. Fr. Med. Emergency 2019; 9: 44-5. |
| [4] | George Bouras, Sorinel Lunca, Michel VixMD Jacques Marescaux. A Case of Emphysematous Cholecystitis Managed by Laparoscopic Surgery. JSLS. 2005; 9(4): 478-80. |
| [5] | Hiroyuki Miyahara, Dai Shida, Hiroki Matsunaga, Yukiko Takahama, Sachio Miyamoto. Emphysematous cholecystitis with massive gas in the abdominal cavity. World J Gastroenterol 2013; 19(4): 604-06. |
| [6] | D. Naouri, R. Rozenfeld, O. Ganansia. Cholecystitis emphysematous: a rare and underestimated emergency. Ann. Fr. Med. Emergency 2014; 4: 415-16. |
| [7] | O. Mercier, H. Kotobi, G. Godiris-Petit. Gallot. Emphysematous cholecystitis: a pathological entity. About a case. Annals of Surgery 128. 2003; 716-8. |
| [8] | Supreet Khare, Aswini K Pujahari. A rare case of emphysematous cholecystitis. J Clin Diagn Res 2015; 9 (9): 13-4. |
| [9] | Ming-Yu Chen, Chen Lu, Yi-fan Wang, Xiu-Jun Cai. Emphysematous cholecystitis in a young male without predisposing factors. Medicine 2016; 95(44); 1-4. |
| [10] | Asli Tanrivermis Sayit, Hediye Pinar Gunbey. Emphysematous Cholecystitis in 24-Year-old Male Without Predisposing Factors. Journal of Clinical and Diagnostic Research. 2015; 9(7): 1-2. |
| [11] | Lindsey I, Kitchen G, Leung D. Emphysematous cholecystitis. Aust N Z J Surg 1996; 66: 267–8. |
| [12] | Hideki Katagiri, Yasuo Yoshinaga, Yukihiro Wear, Ken Mizokami. Emphysematous Cholecystitis Successfully Treated by Laparoscopic Surgery. Journal of Surgical Case RepLocation 2014; 4: 1-2. |
| [13] | J. W. Hazey, F. J. Brody, S. M. Rosenblatt, J. Brodsky, J. Malm, J. L. Ponsky. Laparoscopic management and clinical outcome of emphysematous cholecystitis. Surg Endosc 2001; 15: 1217-20. |
APA Style
Bi Kalou Ismaèl, L., Inza, B., Amos Serge, E., Blaise Amos, K., Mzahem, G., et al. (2023). Emphysematous Cholecystitis a Rare and Serious Clinical Entity: A Case Report of 6 Patients. Journal of Surgery, 11(6), 136-139. https://doi.org/10.11648/j.js.20231106.13
ACS Style
Bi Kalou Ismaèl, L.; Inza, B.; Amos Serge, E.; Blaise Amos, K.; Mzahem, G., et al. Emphysematous Cholecystitis a Rare and Serious Clinical Entity: A Case Report of 6 Patients. J. Surg. 2023, 11(6), 136-139. doi: 10.11648/j.js.20231106.13
AMA Style
Bi Kalou Ismaèl L, Inza B, Amos Serge E, Blaise Amos K, Mzahem G, et al. Emphysematous Cholecystitis a Rare and Serious Clinical Entity: A Case Report of 6 Patients. J Surg. 2023;11(6):136-139. doi: 10.11648/j.js.20231106.13
Share This Article
Twitter
Linked In
Facebook
Copy
Download@article{10.11648/j.js.20231106.13,
author = {Leh Bi Kalou Ismaèl and Bamba Inza and Ekra Amos Serge and Kouakou Blaise Amos and Ghassam Mzahem and Dager Nahed},
title = {Emphysematous Cholecystitis a Rare and Serious Clinical Entity: A Case Report of 6 Patients},
journal = {Journal of Surgery},
volume = {11},
number = {6},
pages = {136-139},
doi = {10.11648/j.js.20231106.13},
url = {https://doi.org/10.11648/j.js.20231106.13},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20231106.13},
abstract = {Introduction: Emphysematous cholecystitis or pneumocholecystitis is a condition caused by gas-forming microorganisms that cause ischemia and necrosis of the vesicular wall. It is characterized by the presence of gas in the wall and lumen of the gallbladder. Its incidence is higher in diabetics. It is a rare disease entity responsible for high mortality. However, early diagnosis combined with prompt and appropriate treatment can prevent the progression to septic shock and then death. The objective of this study was to describe the diagnostic and prognostic aspects, in order to enrich the limited literature concerning this pathology. Patients and methods: This was a descriptive retrospective study that ran from January 2019 to December 2021. It concerned patients admitted for emphysematous cholecystitis. Results: We collected 6 records of patients admitted for 6 emphysematous cholecystitis. They accounted for 1.8% of all cholecystectomies (n=278) and 4% of emergency cholecystectomies (n=112). These were 4 men (67%) and 2 women (33%). The mean age was 76.4 years. Patients generally had several histories, including the hypertension-diabetes couple, but 1 patient did not have diabetes. The average consultation time was 3 days. The clinical picture was acute generalized peritonitis in 1 patient and localized irritation to the right hypochondrium in 5 patients with septic shock. The diagnosis in all patients was made by abdominal CT scan. One patient had an ASA IV score, the other 5 patients had a score from ASA to III. In all cases, after intense resuscitation, cholecystectomy was performed, of which four (67%) were performed laparoscopically and 2 (33%) were performed by laparotomy. Bacteriology of bile fluid revealed gram-negative baccilia (E. coli, Citrobacter koseri) and gram-positive cocci (staphylococcus aerus) in 5 cases and 1 case of sterile fluid. The mean length of hospital stay was 5 days (range: 5-18 days). The morbidity was a case of parietal suppuration treated with local dressing. No deaths. Conclusion: Rare pathology. Diagnosis is essentially based on imaging, in this case abdominal CT scans. The prognosis depends on early and appropriate medical-surgical management.
},
year = {2023}
}
TY - JOUR T1 - Emphysematous Cholecystitis a Rare and Serious Clinical Entity: A Case Report of 6 Patients AU - Leh Bi Kalou Ismaèl AU - Bamba Inza AU - Ekra Amos Serge AU - Kouakou Blaise Amos AU - Ghassam Mzahem AU - Dager Nahed Y1 - 2023/12/06 PY - 2023 N1 - https://doi.org/10.11648/j.js.20231106.13 DO - 10.11648/j.js.20231106.13 T2 - Journal of Surgery JF - Journal of Surgery JO - Journal of Surgery SP - 136 EP - 139 PB - Science Publishing Group SN - 2330-0930 UR - https://doi.org/10.11648/j.js.20231106.13 AB - Introduction: Emphysematous cholecystitis or pneumocholecystitis is a condition caused by gas-forming microorganisms that cause ischemia and necrosis of the vesicular wall. It is characterized by the presence of gas in the wall and lumen of the gallbladder. Its incidence is higher in diabetics. It is a rare disease entity responsible for high mortality. However, early diagnosis combined with prompt and appropriate treatment can prevent the progression to septic shock and then death. The objective of this study was to describe the diagnostic and prognostic aspects, in order to enrich the limited literature concerning this pathology. Patients and methods: This was a descriptive retrospective study that ran from January 2019 to December 2021. It concerned patients admitted for emphysematous cholecystitis. Results: We collected 6 records of patients admitted for 6 emphysematous cholecystitis. They accounted for 1.8% of all cholecystectomies (n=278) and 4% of emergency cholecystectomies (n=112). These were 4 men (67%) and 2 women (33%). The mean age was 76.4 years. Patients generally had several histories, including the hypertension-diabetes couple, but 1 patient did not have diabetes. The average consultation time was 3 days. The clinical picture was acute generalized peritonitis in 1 patient and localized irritation to the right hypochondrium in 5 patients with septic shock. The diagnosis in all patients was made by abdominal CT scan. One patient had an ASA IV score, the other 5 patients had a score from ASA to III. In all cases, after intense resuscitation, cholecystectomy was performed, of which four (67%) were performed laparoscopically and 2 (33%) were performed by laparotomy. Bacteriology of bile fluid revealed gram-negative baccilia (E. coli, Citrobacter koseri) and gram-positive cocci (staphylococcus aerus) in 5 cases and 1 case of sterile fluid. The mean length of hospital stay was 5 days (range: 5-18 days). The morbidity was a case of parietal suppuration treated with local dressing. No deaths. Conclusion: Rare pathology. Diagnosis is essentially based on imaging, in this case abdominal CT scans. The prognosis depends on early and appropriate medical-surgical management. VL - 11 IS - 6 ER -
Department of General and Digestive Surgery, University Hospital of Bouaké, Bouaké, Côte d'Ivoire
Information