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[Emphysematous cholecystitis (author's transl)].

H Tögel, P Sommer

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

    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.

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    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.