Clostridial cholecystitis--the need for early recognition and treatment.

There remains some controversy regarding the timing of cholecystectomy after an attack of acute cholecystitis. Opinions vary between early operation within two and seven days and delayed operation readmitting the patient eight to twelve weeks later. There is, however, a small group of patients who require prompt emergency cholecystectomy. This group includes patients presenting with cholecystitis complicated by gas-forming organisms where the plain abdominal gas-forming organisms where the plain abdominal radiograph can establish the diagnosis.