Case report describes concurrent emphysematous cholecystitis and cholangitis in a patient with ischemic bowel, indicating urgent intervention is vital.
Objective To describe a rare case of concurrent emphysematous cholecystitis, emphysematous cholangitis, and ischemic bowel in an older patient. Case Presentation: An 88-year-old man with end-stage renal disease on hemodialysis presented with abdominal pain and altered mental status. Computed tomography revealed intramural gas in the gallbladder and distal common bile duct. Emergency laparotomy confirmed a gangrenous gallbladder and ischemic bowel. Bile cultures grew Clostridium perfringens and Streptococcus anginosus . Postoperative bile leakage was successfully managed using endoscopic retrograde cholangiopancreatography and biliary stenting. Conclusions Emphysematous cholangitis is a life-threatening condition requiring prompt computed tomography–based diagnosis and urgent multidisciplinary management with antibiotics, surgery, and endoscopic intervention.
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Wu et al. (2026) studied this question.
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