Survival in a Case of Emphysematous Cholecystitis With Sepsis Caused by Clostridium Perfringens

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2023 Nov 30

PMID 38033444

Authors

Yuki Hoshi

Kaoru Takeshima

Shinsei Matsuoka

Tatsuhiko Hoshikawa

Koji Senuma

Takeshi Nakamura

Masashi Tsugita

Makoto Nakamaru

Affiliations

Soon will be listed here.

Abstract

A 77-year-old man presented to the Department of Internal Medicine with a chief complaint of abdominal pain. During the outpatient examination, a computed tomography (CT) scan showed gallstones. The patient developed worsening abdominal pain and fever and was admitted to the emergency department. He was diagnosed with cholecystitis and hospitalized. Treatment with antimicrobial agents was initiated. On the second day of hospitalization, the patient developed a fever of 39°C, hypotension, and oliguria. An emergency CT scan was performed, which showed gas production in the gallbladder. He was diagnosed with emphysematous cholecystitis, and emergency percutaneous transhepatic gallbladder drainage was performed. The patient was transferred to the high-care unit, and intensive care was initiated. On the eighth day, a follow-up CT scan showed an abscess in the gallbladder bed, and drainage was performed percutaneously. His general condition gradually improved, and he was discharged from the hospital on day 24. The patient was readmitted for cholecystectomy three months after the initial admission. The prognosis of sepsis caused by is extremely poor, with a mortality rate of 70%-100%. We present a case of emphysematous cholecystitis successfully treated with multimodal treatment despite the presence of sepsis due to and discuss the possible prognostic factors by reviewing the literature.

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