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Question
65 year-old diabetic patient presents with abdominal pain. What's the abnormality on Xray?
Answer
Emphysematous Cholecystitis
Emphysematous Cholecystitis
- More common in elderly patients, especially with diabetes
- Usually due to ischemia secondary to systemic hypoperfusion, atherosclerosis, embolism, or vasculitis
- Common organisms causing infection include Clostridium, E. Coli, Klebsiella, and anaerobic streptococci.
- Early antibiotic treatment is mandatory, but definitive surgery is typically required
- Air-fluid level and distended gallbladder may be seen on upright plain abdominal radiographs; CT scan demonstrates air in the GB wall and sometimes throughout the biliary tree
References
Carrascosa MF, et al. Emphysematous Cholecystitis. CMAJ.10 Jan 2012; 184(1): E81
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