Effervescent gallbladder: sonographic findings in emphysematous cholecystitis

Area of Science:

• Gastroenterology and Hepatology
• Medical Imaging
• Surgical Pathology

Background:

• Emphysematous cholecystitis is a rare, severe form of acute cholecystitis.
• It is characterized by the presence of gas within the gallbladder wall or lumen.
• Prompt diagnosis and surgical intervention are crucial for patient outcomes.

Observation:

• A unique sonographic finding termed
• effervescent gallbladder
• was observed.
• This appearance mimics bubbles rising in champagne, originating from the gallbladder's dependent portion.
• The gas accumulation resulted from acute distal common bile duct obstruction by a gallstone.

Findings:

• The underlying cause was identified as acute obstruction of the distal common bile duct by a gallstone.
• Purulent cholangitis was also present, contributing to the gas formation.
• The sonographic
• effervescent gallbladder
• sign is a specific indicator of this condition.

Implications:

• This distinctive sonographic finding aids in the early diagnosis of emphysematous cholecystitis.
• Timely diagnosis facilitates appropriate and potentially life-saving surgical management.
• Short-term follow-up sonography is recommended to confirm the diagnosis and monitor disease progression.