Emphysematous Cholecystitis

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Abstract
EMPHYSEMATOUS cholecystitis is an uncommon variant of acute cholecystitis, in which the causative agent is a gas-producing bacteria. Recent experience with a patient who manifested emphysematous cholecystitis stimulated this report. Report of a Case A 73-year-old man with adult-onset diabetes was admitted with a three-day history of right upper quadrant abdominal pain radiating to his back. His medical history was significant for a myocardial infarction eight years earlier and diabetes, which was controlled by diet. On admission, his temperature was 36.6 °C rectally, vital signs were stable, and an abdominal examination disclosed localized right upper quadrant peritonitis. Laboratory analyses on admission disclosed the following values: WBCs, 15,000/cu mm (84% polymorphonuclear cells, 7% band forms); hematocrit, 47%; ESR, 42 mm/hr; serum amylase, 4 units/L; blood glucose, 302 mg/dL; urinalysis—specific gravity 1.032/5, acetone 2+, WBCs two to five, RBCs two to four; total bilirubin, 1.1 mg/dL; direct bilirubin, 0.3 mg/dL; alkaline phosphatase,

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