Faculty of Medicine

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    Air where it shouldn’t be! Incidental diagnosis of emphysematous cholecystitis
    (AMO Publisher, Lviv, Ukraine, 2025-09)
    Marija Serafimovska
    ;
    Bozhidar Blazhevski
    ;
    Emphysematous cholecystitis (EC) is a rare, potentially fatal variant of acute cholecystitis, caused by gas-forming organisms in the gallbladder wall. It most commonly affects elderly, diabetic, or immunocompromised patients, and can progress rapidly to perforation, sepsis, or death if not recognized early. A 71-year-old male was referred to our pulmonology department for exacerbation of chronic lung disease. Laboratory workup showed elevated C-reactive protein levels. A non-enhanced and contrast-enhanced multidetector computed tomography (MDCT) scan of the thorax revealed no acute pulmonary pathology, but proximal abdominal cuts incidentally demonstrated air inclusions within the gallbladder wall, highly suggestive of EC. The finding prompted further evaluation for anaerobic infection and consideration of urgent management. EC is typically associated with gallstones, vascular compromise, or systemic conditions such as diabetes, but may also occur in their absence. This case highlights the role of cross-sectional imaging in detecting unsuspected abdominal pathology and underlines the importance of carefully reviewing all structures visible on a scan, even when outside the primary area of interest Incidental recognition of EC can be life-saving, as timely diagnosis allows for early intervention and reduced risk of complications. For medical residents and junior clinicians, awareness of its radiologic appearance and risk factors is essential to ensure prompt, effective management.
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    Emphysematous Calculous Cholecystitis Diagnosed with Abdominal CT in a Diabetic Female Patient - Case Report
    (Walter de Gruyter GmbH, 2023-12)
    Misimi, Shqipe
    ;
    Aliu, Ilir
    ;
    Kanevce, Petar
    ;
    Emphysematous cholecystitis is reported to have a low incidence of less than 1% in all cases of acute cholecystitis and yet a high mortality rate of up to 15%. It is most commonly seen in male diabetic patients with advanced age. The diagnosis is established with the presence of gas in the gallbladder lumen and/or within its wall which can be seen on plain abdominal radiography, abdominal ultrasound, and abdominal computerized tomography. The clinical presentation refers to one of acute cholecystitis, but the treatment requires prompt cholecystectomy since the patient's condition can deteriorate due to the possibility of gallbladder perforation. We present a case of a 71-year-old female diabetic patient with calculous emphysematous cholecystitis treated with emergency open cholecystectomy.