Inside the upper right part of your abdomen, below your liver, is a small, pear-shaped organ called the gallbladder (unless you’ve already had yours removed). The gallbladder’s job is to store and release a type of liquid called bile.
Bile is made in the liver. It helps break down and absorb fats that come from the food you eat. This makes them more easily digested when they’re released from the gallbladder into the first part of your small intestine, called the duodenum.
Sometimes bile can get trapped in the gallbladder and causes intense, sudden pain; redness; irritation; and inflammation. This condition is called cholecystitis.
In some cases, cholecystitis attacks are acute, meaning they happen suddenly. In other cases, they are chronic, meaning they happen repeatedly over time.
Emphysematous cholecystitis is a rare but very serious type of acute cholecystitis that can quickly become life threatening without immediate emergency medical treatment.
Emphysematous cholecystitis is considered a life threatening medical emergency.
If you are experiencing sudden and severe pain in the upper right part of your abdomen, call 911 or your local emergency services number right away.
You need immediate treatment for emphysematous cholecystitis in order to avoid potentially life threatening complications related to gallbladder blockage and trapped bile.
Cholecystitis most often occurs when hardened lumps of bile called gallstones form and block the tube that drains bile from the gallbladder into the small intestine.
In other cases, cholecystitis can be caused by:
- bacterial infection
- tumors in the liver or pancreas
- diabetes, which can cause reduced blood supply to the gallbladder
- gallbladder sludge, which most commonly affects pregnant people or people who have experienced rapid weight loss
Emphysematous cholecystitis is caused by gas-forming bacteria that infect the gallbladder following necrosis (organ death) in the gallbladder due to a lack of blood supply. This lack of blood supply occurs as a result of severe or long-term inflammation, and it causes the gallbladder wall tissue to begin to die. The dead tissue holds the bacteria that releases gas into the gallbladder.
The most common types of bacteria causing emphysematous cholecystitis include:
- Clostridium perfringens
- Clostridium welchii
- Escherichia coli
People with diabetes appear to have an increased risk of these bacteria growing in their bodies, according to
Without treatment, gas will build up to the point that it fills the entire gallbladder. It may potentially cause gangrene and lead the gallbladder to rupture. A ruptured gallbladder often causes temporary intense, sharp pain. This can lead to life threatening sepsis or infection.
Up to half of people who experience emphysematous cholecystitis have diabetes. This is higher in men.
According to a
This condition also tends to affect people who are age 45 or older, the same case report suggests.
Symptoms of emphysematous cholecystitis are similar to acute cholecystitis. In many cases, symptoms are initially not easily obvious — but they rapidly become worse without treatment.
- sudden and severe pain in the upper right part of your abdomen
- pain extending to your back or below the right shoulder blade, which usually gets worse when you take deep breaths
- nausea and vomiting
- loose and light-colored bowel movements
- bloated abdomen
- yellowed skin and eyes (jaundice)
If left untreated, emphysematous cholecystitis can progress to life threatening conditions like:
You should never ignore the symptoms of emphysematous cholecystitis. Because this condition can be fatal, it’s important to call 911 or your local emergency services number right away.
A healthcare professional can diagnose emphysematous cholecystitis by taking a medical history and physical examination, along with additional tests.
In cases of emphysematous cholecystitis, imaging will show the presence of gas and gas bubbles inside the gallbladder or in the gallbladder walls. Sometimes, imaging tests will also show a collection of fluid in the gallbladder.
Additionally, bile cultures in cases of emphysematous cholecystitis will show the growth of bacteria.
Rapid, early treatment of emphysematous cholecystitis is important to prevent the lethal complications that this condition can cause. The main treatment for this emergency condition is gallbladder removal surgery (cholecystectomy).
The type of surgery depends on the condition of the gallbladder. A surgeon may use low risk laparoscopic surgery or, in more urgent cases, open gallbladder surgery.
The overall risks of gallbladder surgery include:
Some doctors may prescribe pain relievers or antibiotics to help with recovery from surgery. Supportive care, such as IV fluids, may also be administered in the hospital to help stabilize someone with advanced emphysematous cholecystitis.
Most side effects from gallbladder surgery are temporary. These include:
- abdominal and shoulder pain (if gas has been used to inflate your abdomen during surgery)
- bloating, diarrhea, and flatulence (which can last a few weeks and can be minimized by consuming high fiber foods or taking medication)
- nausea (from anesthetic and pain relievers)
- swelling, bruising, and pain around the surgery site
For people who have had laparoscopic surgery, they can often leave the hospital on the day of their surgery and return to their usual activities in about 2 weeks, according to the U.K.’s National Health Service.
It takes about 3 to 4 weeks to return to your typical activities following open gallbladder surgery, the NHS says, and up to 8 weeks if you have had more extensive open surgery.
The NHS recommends having someone stay with you for at least 24 hours following gallbladder surgery, since you may continue to experience the effects of the anesthetic.
In rare cases following surgery, people may continue to experience cholecystitis symptoms. This is called post-cholecystectomy syndrome.
- abdominal pain
You can manage these symptoms with medication, and they often lessen over time.
If you experience fever or severe pain (which can be signs of infection), call emergency medical services or go to the nearest emergency room right away.
Our bodies can still function well without a gallbladder. Prompt treatment of emphysematous cholecystitis can minimize the risk of complications following surgery and can save your life.
Emphysematous cholecystitis is a rare and life threatening form of acute cholecystitis that requires immediate emergency medical treatment.
Gallbladder removal surgery is required to treat this severe condition. With surgery, most people who experience emphysematous cholecystitis make a full recovery.
If you notice any of the signs of cholecystitis, particularly if you have diabetes, are biologically male, and are age 45 or older, call emergency medical services right away.