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Asymptomatic emphysematous cholecystitis.

Hideo Ohno1, Hideaki Ishida2, Tomoya Komatsuda2

  • 1Department of Gastroenterology, Red Cross Hospital, 222-1 Naeshirozawa, Saruta, Kamikitate, Akita, 010-1495, Japan. ohno@archosp-1998.com.

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PubMed
Summary

Emphysematous cholecystitis, a rare complication of acute cholecystitis, can be asymptomatic. Gas echoes on ultrasound (US) in the gallbladder wall and liver are key diagnostic findings, enabling prompt treatment.

Keywords:
ArtifactEmphysematous cholecystitisGallbladderThree-dimensional ultrasonographyUltrasound

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Area of Science:

  • Gastroenterology and Hepatology
  • Diagnostic Imaging

Background:

  • Emphysematous cholecystitis (EC) is a severe, potentially fatal complication of acute cholecystitis.
  • EC typically presents with vague symptoms, making early diagnosis challenging.
  • Asymptomatic presentations of EC are exceptionally rare.

Purpose of the Study:

  • To report a rare case of asymptomatic emphysematous cholecystitis.
  • To highlight the critical role of specific sonographic (US) findings in diagnosing this condition.
  • To emphasize the importance of recognizing US signs for timely intervention.

Main Methods:

  • Case presentation of a patient with asymptomatic emphysematous cholecystitis.
  • Detailed analysis of sonographic (US) imaging findings.
  • Correlation of imaging findings with clinical management and outcome.

Main Results:

  • The case involved the detection of gas echoes within the gallbladder wall and adjacent hepatic tissue on US.
  • These specific US findings were crucial for identifying the condition despite the absence of typical symptoms.
  • Prompt treatment was initiated based on the sonographic evidence.

Conclusions:

  • Asymptomatic emphysematous cholecystitis, though rare, must be considered in the differential diagnosis.
  • Sonography (US) is the primary imaging modality for gallbladder diseases and can reveal characteristic signs of EC.
  • Early identification of US findings, such as intramural and hepatic gas, is vital for preventing delayed treatment and improving patient outcomes.