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[Emphysematous cholecystitis (author's transl)].

H Tögel, P Sommer

    MMW, Munchener Medizinische Wochenschrift
    |April 24, 1981
    PubMed
    Summary

    Emphysematous cholecystitis, a severe acute cholecystitis, is diagnosed preoperatively via radiology detecting gas in or around the gallbladder. This condition often affects diabetics and may not involve gallstones, with variable bacterial presence.

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    Area of Science:

    • Gastroenterology
    • Radiology
    • Infectious Diseases

    Background:

    • Emphysematous cholecystitis represents a severe, potentially life-threatening variant of acute cholecystitis.
    • Early and accurate preoperative diagnosis is crucial for effective management.

    Observation:

    • Radiological findings are key for preoperative diagnosis, specifically identifying gas within the gallbladder wall, lumen, or surrounding tissues.
    • Cholelithiasis (gallstones) is present in only 50% of cases.
    • The condition disproportionately affects males and individuals with diabetes mellitus.

    Findings:

    • Clostridia species are the predominant causative organisms in positive bacteriological cultures.
    • Approximately 50% of cases exhibit negative bacteriology, complicating definitive microbial identification.

    Implications:

    • Radiological detection of gas is paramount for timely diagnosis of emphysematous cholecystitis.
    • Understanding the association with diabetes and variable presentation of gallstones aids clinical suspicion.
    • The high rate of negative bacteriology underscores the importance of imaging in diagnosis and management decisions.

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