Pneumomediastinum as a complication of emphysematous cholecystitis: Case report

Abstract

Background: Emphysematous cholecystitis is a variant of acute cholecystitis which is generally caused by gas-forming organisms. Emphysematous cholecystitis may cause gas spreading within the subcutaneous tissue, peritoneal cavity and retroperitoneum.Case presentation: We present a case of emphysematous cholecystitis in a middle-aged diabetic patient who, postoperatively, presented edema in both flanks and left chest crepitation on palpation, associated with hemodynamic worsening. Computed tomography scan of the chest and abdomen revealed a large pneumomediastinum, pneumoretroperitoneum, gas in subcutaneous tissue and flank abscesses. In both blood and surgical wound exudate cultures, Escherichia coli was found.Conclusion: Emphysematous cholecystitis should be considered as a possible cause of pneumomediastinum. © 2010 Delgado-Plasencia et al; licensee BioMed Central Ltd.