Colecistitis enfisematosa: Manejo satisfactorio por vía laparoscópica / Emphysematour cholecystitis: satisfactory outcome by laparoscopically managment

La colecistitis enfisematosa es una rara forma de presentación de la colecistitis aguda. Es causada por isquemia vascular y se caracteriza por la presencia de gas en la pared, en la luz o en ambas, la cual puede evolucionar a un cuadro de extrema urgencia asociada a una alta tasa de morbilidad y mortalidad. Se presenta un caso de un paciente con un cuadro de dolor abdominal con síntomas gastrointestinales y signos de respuesta inflamatoria sistémica con diagnóstico presuntivo de colecistitis enfisematosa que se realizó una colecistectomía laparoscopia de urgencia, con una adecuada evolución postoperatoria

Emphysematous cholecystitis is an uncommon variant of acute cholecystitis. It is caused by a vascular ischemia and characterized by the presence of gas in the wall, in the lumen, or in both. It can evolve into a life-threatening condition associated with a high rate of morbidity and mortality. We present a case of a patient who presented with abdominal pain, gastrointestinal symptoms, and signs of a systemic inflammatory response with a presumptive diagnosis of emphysematous cholecystitis. An emergency laparoscopic cholecystectomy was performed, with an adequate postoperative evolution

Spontaneous Hepatic Hemorrhage Caused by Emphysematous Cholecystitis: A Case Report and Literature Review.

BACKGROUND: Emphysematous cholecystitis and spontaneous hepatic hemorrhage are uncommon and serious conditions with non-specific presentations that can lead to a poor clinical outcome. We report a case of spontaneous hepatic hemorrhage of emphysematous cholecystitis. A 49-year-old male presented to the emergency department with fever, chills, right upper quadrant pain, vomiting, and diarrhea of four days' duration. He had a history of diabetes mellitus, hypertension, and uarthritis. Computed tomography (CT) revealed an enlarged gallbladder with intra-luminal, intra-mural, and peri-cholecystic air; subcapsular high-density fluid collection; and an intra-hepatic mass with gas and liquid in the right lobe of the liver. After receiving prompt administration of appropriate antibiotic agents, drainage, and an alternative operation the patient recovered well. CONCLUSION: Emphysematous cholecystitis is potentially fatal because of its serious complications. It needs to be diagnosed promptly, not only based on the effervescent gallbladder sign but also on the inflammatory presentations. Furthermore, for patients with spontaneous hepatic hemorrhage, attention should be paid to the underlying cause. Treatment should be individualized to improve diagnosis and cure as early as possible, thereby improving prognosis.

Emphysematous cholecystitis: Imaging findings.

We report a case of emphysematous cholecystitis. We also offer a review of the literature, emphasizing the clinical features, pathogenesis, imaging features and treatment of this surgical condition. Early recognition and surgical consultation are vital in these patients. The significance of plain abdominal radiographs, ultrasonography, CT and RM studies is discussed. Diagnostic problems are mentioned to help understand this rare clinical condition.

Emphysematous cholecystitis complicating liver abscess due to Clostridium baratii infection.

Clostridium baratii bacteremia is a rare but severe anaerobic infection. Its major clinical features are neurological presentation, and significant risk factors include hemodialysis, intestinal disease or malignancy. We describe a case of emphysematous cholecystitis complicated by a liver abscess due to C baratii infection in a healthy adult without neurological manifestation.

Liver enzyme elevation and normal pulmonary function in an adult with a declining forced expiratory volume in 1 second.

This article presents a case report of a 41-year-old male firefighter with cholecystitis and a history of mildly elevated alanine aminotransferase. Liver biopsy showed periodic acid Schiff-positive, diastase-resistant periportal globules. Retrospective review of clinical data revealed progressive lung function decline despite absent pulmonary symptoms and normal pulmonary function testing. The following disorders should be considered in any patient with elevated transaminases without an apparent etiology: viral hepatitides, medication toxicity, autoimmune hepatitis, alcohol-induced hepatic injury, and alpha-1-antitrypsin deficiency.

Patient with perforation caused by emphysematous cholecystitis who showed flare on the skin of the right dorsal lumbar region and intraperitoneal free gas.

We report an 84-year-old man with perforation caused by emphysematous cholecystitis who showed flare on the skin of the right dorsal lumbar region and intraperitoneal free gas. The patient was admitted for abdominal pain, abdominal swelling, and consciousness disorder 18 days after the onset. Abdominal computed tomography (CT) revealed emphysema in the gallbladder and a small amount of intraperitoneal free gas. Intraoperative findings suggested gangrenous cholecystitis. The gallbladder wall was perforated, and an abscess involving the right subphrenic region, the periphery of the liver and gallbladder, and the right paracolonic groove, was detected. The flare on the body surface may have reflected abscess formation in the right abdominal cavity. Emphysematous cholecystitis induces necrosis and perforation in many patients, and immediate strategies such as emergency surgery are important.