A case report of emphysematous cholecystitis associated with pneumobilia in a diabetic patient

Abstract

Background: Emphysematous cholecystitis is an uncommon variant of acute cholecystitis that could be life threatening if not promptly diagnosed and managed.

Case report: We report a 65 year old male diabetic who wasadmitted through the surgical emergency unit of Trauma and Surgical Centre, Ondo City on account of eleven day history of right sided upper abdominal pain and vomiting. Investigation showed elevated randomblood glucose of 24mmol/l, glycated hemoglobin of 9.5%, hematocrit of 20% and white blood count of 6,700 cells/mm³. Abdominal computerized tomography scan showed air in the wall and lumen of gallbladder and common bile duct thereby confirming a diagnosis of emphysematous cholecystitis associated with pneumobilia.He was transfused andtreated with intravenous antibiotics and insulin. Hethereafter had an emergency open cholecystectomy without any postoperative complication.

Conclusion: This case highlights an unusual presentation of this rare condition and the need for high index of suspicion in order to prevent associated morbidity and mortality.

Keywords: Emphysematous, Cholecystitis, Diabetes mellitus