Emphysematous cholecystitis: an insidious variant of acute cholecystitis.

Emphysematous cholecystitis is an insidious and rapidly progressing disease that requires prompt surgical intervention. As the majority of the patients contracting this disease initially present to the emergency department with complaints of abdominal pain and often mild constitutional symptoms, it is important for the emergency physician to be aware of this clinical entity. Didactic cases have been presented that, in many ways, illustrate classic examples of emphysematous cholecystitis, the diagnosis of which can often be made in the emergency department using an upright abdominal radiograph.