Emphysematous hepatitis: a very rare entity with a poor prognosis.

A 67-year-old female, with no alterations in glucose metabolism or other relevant history, presented to the Emergency Department due to abdominal pain and vomiting after a syncopal episode. Physical examination revealed a poor general condition, mild stupor and a distended abdomen, painful on palpation in the right hypochondrium, with localized rigidity. On arrival at the Emergency Department, the patient's blood pressure (BP) was 150/66 mmHg, heart rate (HR) was 110 beats/minute and temperature 35 °C.