Abstract
We present a rare case of gallbladder carcinoma associated with acute emphysernatous cholecystitis. A 77-year old women was admitted with complaints of righthypochondralgia, fever and jaundice.'The laboratory data on admission revealed mildleukocytosis, increased CRP, jaundice and liver injury. Abdominal plain film and CT scanshowed extensive gas in the gallbladder and the intrahepatic bile ducts. ERCP(endoscopic retrograde eholangiopancreategraphy)revealed the filling defect of the wall of the gallbladder and debris. With a diagnosis of emphysematous cholecystitis by imaging study, thepatient was treated with intravenous alimentation and antibiotics. However, the gallbladder carcinoma could not completely be ruled out, surgical operation was performed 45 daysafter admission. Muddy material without stone and turnor were present in the gallbladder.The histopathological findings of the resected gallbladder showed poorly differentiatedtubullar adenacarcinoma. In this case, unclear images due to severe inflammation prevented us from making appropriate preoperative diagnosis. Even if image diagnoses could notoffer the apparent evidence of carcinoma, careful observation and inspection should becarried out with consideration of hidden malignancy.
