Emphysematous cholecystitis

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1. Emphysematous Cholecystitis Pricilia Donna Esperansa Sea 2012 060 106 2. Emphysematous Cholecystitis EC is a severe form of acute colesystitis. Rapidly fatal, risk for gangrene and perforation, high risk mortality. Life-threathening anaerobic infection. Gas-forming bacteria (Clostridium welchii/perfingrens, Escherichia coli and Bacteroides fragilis) Men are affected twice as commonly as women. Mostly patients are between 50 and 70 years of age, and have underlying diabetes melitus. Can be detected using CT or USG. Gas in gallblader or abnormal communication with GIT Pain in right upper quadrant. 3. Plain Abdominal Radiograph Abdominal radiograph (frontal projection) shows intraluminal air (arrow) with airfluid levels http://www.ncbi.nlm.nih.gov/pmc/articles/P MC3137852/#!po=50.0000 4. USG Sagittal (A) and axial (B) USG images show sludge (black arrow) and wall thickening (arrow in A) of the gall bladder, consistent with acute cholecystitis with echogenic shadowing foci (arrow in B) within the biliary system http://www.ncbi.nlm.nih.gov/pmc/articles/P MC3137852/#!po=50.0000 5. Sagittal USG image of the gall bladder shows multiple speckled echogenic bands (arrows), with acoustic shadowing within its wall (arrowhead) http://www.ncbi.nlm.nih.gov/pmc/articles/P MC3137852/#!po=50.0000 6. CT Axial CT scan shows air (arrow) in the gall bladder lumen with an airfluid level http://www.ncbi.nlm.nih.gov/pmc/articles/P MC3137852/#!po=50.0000 7. Axial CT scan shows intramural air in the gall bladder (arrow), with cholelithiasis (arrowhead) http://www.ncbi.nlm.nih.gov/pmc/articles/P MC3137852/#!po=50.0000 8. Emphysematous cholecystitis in a 47-year-old man with diabetes who experienced abdominal pain. This computerized tomography scan shows gas within the wall of the gallbladder (horizontal arrow) as well as within the lumen of the gallbladder (verticalarrow).CourtesyofHelenMorehouse,MD. http://emedicine.medscape.com/article/173885- overview#aw2aab6c10 9. Axial CT scan (A) shows an inflamed gall bladder with questionable air in the gall bladder wall (arrow). Coronal reformation (B) confirms air within the gall bladder wall (arrow) suggesting emphysematous cholecystitis http://www.ncbi.nlm.nih.gov/pmc/articles/PMC31 37852/#!po=50.0000 10. MRI Coronal heavily T2-weighted magnetic resonance image shows numerous signal void bubbles (arrowheads) in the lumina of the distended gallbladder and the common bile duct. Courtesy of Radiological Society of North America (RSNA), originally published in Watanabe Y, Nagayama M, Okumura A, et al. MR imaging of acute biliary disorders. RadioGraphics 2007;27:477-95. http://emedicine.medscape.com/article/173885- overview#aw2aab6c10 11. Daftar Pustaka Emphysematous Cholecystitis. April 9, 2015 [cited May 12, 2015]; Retrieved from: http://emedicine.medscape.com/article/173885- overview Sunnapwar A, Raut AA, Nagar AM, Katre R. Emphysematous cholecystitis: Imaging findings in nine patients. Indian J Radiol Imaging. 2011;21(2):1426. http://radiopaedia.org/articles/emphysematous-cholecystitis