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Acute emphysematous cholecystitis. Report of twenty cases
L Garcia-Sancho Tellez1, J A Rodriguez-Montes, S Fernandez de Lis
1Department of Surgery, La Paz University Hospital, Universidad Autonoma de Madrid, Spain. luisgst@jet.es
Hepato-Gastroenterology
|October 16, 1999
Summary
Acute emphysematous cholecystitis (AEC) primarily affects elderly diabetic men and requires prompt surgical intervention. Despite diagnostic advances, this severe gallbladder condition still carries high morbidity and mortality rates.
Area of Science:
- Gastroenterology
- Surgical Pathology
- Medical Diagnostics
Background:
- Acute emphysematous cholecystitis (AEC) is a severe, potentially life-threatening form of acute cholecystitis.
- Characterized by rapid progression, AEC involves early gallbladder gangrene and perforation.
Purpose of the Study:
- To present clinical experience with acute emphysematous cholecystitis.
- To analyze patient demographics, clinical presentation, diagnostic methods, and outcomes.
Main Methods:
- Retrospective review of clinical records for 20 patients diagnosed with AEC.
- Analysis included patient demographics, medical history, symptoms, laboratory results, imaging, operative findings, and microbiological data.
Main Results:
- The study population comprised 13 men and 7 women, with a mean age of 59 years.
- Common comorbidities included diabetes mellitus (11 cases) and gallstones (6 cases).
- Diagnostic imaging (X-ray, ultrasound) achieved 95% accuracy; high rates of gallbladder necrosis (70%) and pericholecystic abscess (80%) were observed, with a 25% mortality rate.
Conclusions:
- AEC predominantly impacts elderly diabetic men.
- Early diagnosis via imaging and emergency surgery are crucial due to high rates of gangrene and perforation.
- Despite advancements, morbidity (50%) and mortality (25%) remain significant challenges in managing AEC.
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