Fulminant emphysematous hepatitis with pneumoperitoneum: A case report

Emphysematous hepatitis is a rare and fulminant gas-forming intra-abdominal infection with a high rate of mortality. Concurrent Type II Diabetes Mellitus is the most common association. It is diagnosed through CT examination with replacement of the liver parenchyma with gas without fluid-containing abscess formation. We describe the case of a gentleman in his sixties presenting with acute abdominal pain, fever and jaundice diagnosed with emphysematous hepatitis via CT with a rapidly progressive and terminal course. The imaging demonstrated large volume intrahepatic gas with pneumoperitoneum. The underlying pathogens isolated were Enterococcus faecium and Clostridium perfringens. This is believed to be the 26th case described in the literature with many similarities to previously published cases.