Yokosuka Ryohsuke, Ishikawa Kazuhiro, Kim Yuntae, Sato Kuniko, Nakamura Kenji, Fukuda Katsuyuki
Department of Gastroenterology, St. Luke's International Hospital, Japan.
Department of Infectious Disease, St. Luke's International Hospital, Japan.
Intern Med. 2025 May 15;64(10):1517-1524. doi: 10.2169/internalmedicine.4219-24. Epub 2024 Oct 18.
Emphysematous cholecystitis has a poor prognosis and necessitates prompt surgery or drainage. Emphysematous cholangitis (EC) is believed to have a similar clinical course, but reports are limited. We herein report the case of a 79-year-old woman who presented with epigastric pain and was diagnosed with EC. Rapid deterioration occurred after admission, requiring intensive and prolonged intravenous antibiotic therapy, despite immediate drainage and antibiotic therapy. We reviewed the background, causative organisms, treatment, and outcomes of EC through a literature search. Our findings provide insights into its similarities to emphysematous cholecystitis, emphasizing the need for expeditious drainage and anaerobic bacterial coverage during antibiotic therapy.
气肿性胆囊炎预后较差,需要及时进行手术或引流。气肿性胆管炎(EC)被认为具有相似的临床病程,但相关报道有限。我们在此报告一例79岁女性患者,她因上腹部疼痛就诊,被诊断为EC。入院后病情迅速恶化,尽管立即进行了引流和抗生素治疗,但仍需要强化和长期的静脉抗生素治疗。我们通过文献检索回顾了EC的背景、致病微生物、治疗方法及结果。我们的研究结果揭示了其与气肿性胆囊炎的相似之处,强调了在抗生素治疗期间进行快速引流和覆盖厌氧菌的必要性。