Early Sonographic Diagnosis of Emphysematous Cholecystitis Successfully Treated with Antibiotics

Abstract

Emphysematous cholecystitis (EC) is an uncommon form of acute cholecystitis, caused by secondary infection of the gallbladder wall with gas-forming organisms. The mortality rate of EC is as high as 25% due to complications such as gangrene, gallbladder perforation, pericholecystic abscess, and bile peritonitis. Traditionally, prompt emergency surgical intervention with open cholecystectomy is recommended for EC treatment. This case study of EC was diagnosed at an early stage with sonography and computed tomography and successfully treated by antibiotic treatment alone without surgery. With characteristic findings on sonography such as echogenic reflectors with posterior shadowing, EC is an important entity for sonographers to be able to identify. In the future as imaging with sonography and CT affords earlier diagnosis of EC, antibiotic therapy might be considered for some patients, but more evidence is needed to obtain the same outcome as this particular case.