Pneumomediastinum as a complication of emphysematous cholecystitis: case report

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 presentationWe 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.

Author: Luciano Delgado-PlasenciaIgnacio Gonzalez-GarciaDiana Rodriguez-GonzalezEsther Torres-Monzon
Credits/Source: BMC Gastroenterology 2010, 10:99

Published on: 2010-09-03

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