Computed tomography-detected concurrent emphysematous cholecystitis and cholangitis with surgically proven ischemic bowel: A case report.

ObjectiveTo describe a rare case of concurrent emphysematous cholecystitis, emphysematous cholangitis, and ischemic bowel in an older patient.Case Presentation: An 88-year-old man with end-stage renal disease on hemodialysis presented with abdominal pain and altered mental status. Computed tomography revealed intramural gas in the gallbladder and distal common bile duct. Emergency laparotomy confirmed a gangrenous gallbladder and ischemic bowel. Bile cultures grew Clostridium perfringens and Streptococcus anginosus. Postoperative bile leakage was successfully managed using endoscopic retrograde cholangiopancreatography and biliary stenting.ConclusionsEmphysematous cholangitis is a life-threatening condition requiring prompt computed tomography-based diagnosis and urgent multidisciplinary management with antibiotics, surgery, and endoscopic intervention.