Emphysematous cholecystitis (EC) is a form of cholecystitis characterized by the presence of intramural or intraluminal gallbladder gas secondary to infection by gas-forming bacteria and is considered a surgical emergency. Computed tomography (CT) is considered the gold standard for the diagnosis of EC, but it can result in increased time to diagnosis and may not be readily available in the emergency department (ED). This delay in diagnosis may contribute to increased rates of gallbladder perforation and associated mortality. As emergency medicine door-to-first-provider times continue to increase, point-of-care ultrasonography (POCUS) can facilitate the diagnosis of this serious condition and expedite definitive care. We present a patient with EC diagnosed using POCUS and highlight the utility of POCUS in the evaluation and management of patients with this rare but serious condition. Therefore, early diagnosis and intervention are critical in the management of patients with EC, and POCUS may play an important role in the rapid diagnosis and definitive care of these patients in the ED setting.
Kons et al. (Wed,) studied this question.