A 75-year-old male with a history of arterial hypertension, diabetes mellitus and hyperlipidemia came to the Emergency Department due to intense, continuous abdominal pain that had lasted for 4 days and was located in the right upper quadrant, accompanied by nausea and vomiting.
Physical examination revealed a protruding abdomen with pain upon superficial palpation of the right hypochondrium and positive Murphy's sign, associated with leukocytosis and neutrophilia.
Simple abdominal radiograph (Fig. 1) showed an oval air image over the hepatic silhouette (white arrows).
Given these radiological findings, the study was completed by abdominal CT (Fig. 2), which demonstrated a distended gallbladder with sludge in its interior and air content associated with emphysematous inflammatory changes of the gallbladder wall (arrowhead).
Diagnosis: acute emphysematous cholecystitis.
Please cite this article as: Guirola Ortíz JA, Mayoral Campos V, Carro Alonso B, Madariaga Ruíz B. Colecistitis aguda enfisematosa. Cir Esp. 2014;92:e13.
