Koole Simone Nienke, Lohman Bjorn Gerardus Petrus Maria, van Unen Josephus Marinus Jacobus
a Department of Surgery , Laurentius Hospital, Roermond , The Netherlands.
Acta Chir Belg. 2016 Feb;116(1):54-7. doi: 10.1080/00015458.2016.1139829.
Emphysematous Cholecystitis is life threatening if left untreated. It is associated with arteriosclerosis, embolic events, and diabetes mellitus. In this report, a patient was presented with an early diagnosis of Emphysematous Cholecystitis and was treated by cholecystectomy without complications. A 46-year-old male presented at the emergency department. Laboratory results as well as the abdominal ultrasound showed no abnormalities. One day after admission, infection parameters started rising. A computed tomography (CT) showed cholecystitis with a circular gas pattern in bile ducts and gallbladder. After treatment with cholecystectomy and antibiotics, the patient recovered uneventfully. The gallbladder mucosa was denaturized with signs of necrosis. The bile culture was positive for Clostridium perfringens. Treatment was based on preoperative antibiotic treatment combined with cholecystectomy. This resulted in early clinical improvement of the patient and normalization of infection parameters. Therefore, the patient was discharged from the hospital four days postoperatively.
气肿性胆囊炎若不治疗会危及生命。它与动脉硬化、栓塞事件和糖尿病有关。在本报告中,一名患者被早期诊断为气肿性胆囊炎,并接受了胆囊切除术,未出现并发症。一名46岁男性到急诊科就诊。实验室检查结果及腹部超声均未显示异常。入院一天后,感染指标开始上升。计算机断层扫描(CT)显示胆囊炎,胆管和胆囊内有圆形气体影。经过胆囊切除术和抗生素治疗后,患者顺利康复。胆囊黏膜变性并有坏死迹象。胆汁培养产气荚膜梭菌呈阳性。治疗基于术前抗生素治疗联合胆囊切除术。这使患者临床症状早期改善,感染指标恢复正常。因此,患者术后四天出院。