山口医学

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山口医学 Volume 52 Issue 6
published_at 2003-12-31

A case of acute emphysematous cholecystitis with typical imaging findings

典型的な画像所見を呈した急性気腫性胆嚢炎の1例
Sato Masako
Kishikawa Hirofumi
Sakaguchi Eiki
Iida Takeshi
Kaino Seiji
Tanabe Mitsuhiko
Sasayama Tetsuro
Itoh Tadahiko
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B030052000612.pdf
Descriptions
Acute emphysematous cholecystitis is a rare disease caused by organisms that produce gas that leaks into the gallbladder lumen and becomes visible on imaging examinations. Here, we report a case of acute emphysematous cholecystitis with a typical presentation. A 73-year-old woman presented with abdominal pain to the emergency department at our hospital. Her temperature was 37.6 ℃ and blood pressure was 126/71mm Hg. On physical examination, her abdomen was flat, soft, and diffusely tender without muscular guarding or rebound tenderness. Laboratory data revealed the following: WBC 12300/mm^3, CRP 7.30 mg/dL, T-bil 1.5 mg/dL, AST 512 IU/L, ALT 297 IU/L, γ-GTP 110 IU/L, ALP 401 U/L. Abdominal ultrasound scan, plain abdominal film, and abdominal computed tomographic images demonstrated gas within the gallbladder wall and intrahepatic ducts. The symptoms and image findings suggested acute emphysematous cholecystitis. Percutaneous transhepatic gallbladder drainage was performed immediately to confirm the diagnosis. Clostridium perfringens was identified in bile culture. We performed laparoscopic cholecystectomy after the patient's general condition improved.
Creator Keywords
気腫性胆嚢炎
経皮経肝胆嚢ドレナージ
PTGBD
Rights
本文データは山口大学医学会の許諾に基づきCiNiiから複製したものである