Abstract
We report a rare case of an emphysematous cholecystitis with an abdominal wall abscess in a diabetic patient. A 70-year-old woman was admitted to our hospital with complaints of fever, right hypochondralgia, and aright hypochondrial tumor. On admission, her diabetic condition was rather poor: blood glucose concentration before lunch was 214 mg/dl, stable HbA1c was 6.3%. Diabetic nephropathy, retinopathy, and neuropathy were not revealed. Abdominal ultrasonography and computed tomography showed air in the intrahepatic bile duct and the choledochus, air and stones in the cholecyst, and an abscess in the abdominal wall continuing from the cholecyst. She was immediately treated by percutaneous transabscess cholecyst drainage. Purulent bile containing Escherichia coli was detected. She had the complications of a diverticulum of the duodenum near the papilla of Vater, and a fistula between the cholecyst and the duodenum. Diabetic patients often have gallstones and occasionally develop emphysematous cholecystitis. We think a strict follow-up of diabetic patients with gallstones is necessary.
