Fulminant emphysematous hepatitis with pneumoperitoneum: A case report

Emphysematous hepatitis is a rare and fulminant gas-forming intra-abdominal infection with a high rate of mortality. Concurrent Type II Diabetes Mellitus is the most common association. It is diagnosed through CT examination with replacement of the liver parenchyma with gas without fluid-containing abscess formation. We describe the case of a gentleman in his sixties presenting with acute abdominal pain, fever and jaundice diagnosed with emphysematous hepatitis via CT with a rapidly progressive and terminal course. The imaging demonstrated large volume intrahepatic gas with pneumoperitoneum. The underlying pathogens isolated were Enterococcus faecium and Clostridium perfringens . This is believed to be the 26th case described in the literature with many similarities to previously published cases.