[A vomiting, old man with abdominal pain and fever].

Emphysematous cholecystitis is a rare presentation of cholecystitis and is caused by gas producing bacteria such as Clostridium perfringens, Klebsiella species or Escherichia coli. We describe a fatal case of a 82-year-old man who presented with abdominal pain, vomiting, fever and acute confusion. An ultrasound and subsequent CT scan showed emphysematous cholecystitis.