Presentation
ICU patient. History of diabetes mellitus.
Patient Data
Age: 80 years
Gender: Female
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The gallbladder is distended and shows diffuse wall thickening with intramural gas. Its lumen shows a gas fluid level and few small dependent high densities suggestive of cholelithiasis.
No extraluminal gas, no pneumobilia, or pneumoperitoneum was identified.
Case Discussion
Features are consistent with emphysematous cholecystitis. It is an uncommon and life-threatening form of acute cholecystitis and is considered a surgical emergency requiring urgent cholecystectomy as it has a high risk of gallbladder gangrene and perforation. It is more common in diabetics and the elderly.
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