{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T08:04:50Z","timestamp":1776845090702,"version":"3.51.2"},"reference-count":6,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2016,1,23]]},"abstract":"<jats:p>An 86-year-old man presented with severe pain in the upper abdomen along with fever. On physical examination, we found an arterial blood pressure of 84\/43\u2005mm\u2005Hg, a heart rate of 80\u2005bpm and a temperature of 38.3\u00b0C. The abdomen was painful and peristalsis was absent. Empiric antibiotic therapy for sepsis was started with amoxicillin\/clavulanate and gentamicin. CT scan of the abdomen revealed an emphysematous cholecystitis. Percutaneous ultrasound-guided cholecystostomy was applied. Bile cultures revealed <jats:italic>Clostridium perfringens<\/jats:italic>. Emphysematous cholecystitis is a life-threatening form of acute cholecystitis that occurs as a consequence of ischaemic injury to the gallbladder, followed by translocation of gas-forming bacteria (ie, <jats:italic>C. perfringens<\/jats:italic>, <jats:italic>Escherichia coli, Klebsiella<\/jats:italic> and Streptococci). The mortality associated with emphysematous cholecystitis is higher than in non-emphysematous cholecystitis (15% vs 4%). Therefore, early diagnosis with radiological imaging is of vital importance.<\/jats:p>","DOI":"10.1136\/bcr-2015-213229","type":"journal-article","created":{"date-parts":[[2016,2,11]],"date-time":"2016-02-11T09:37:08Z","timestamp":1455183428000},"page":"bcr2015213229","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["An 86-year-old man with acute abdominal pain"],"prefix":"10.1136","volume":"2016","author":[{"given":"Paul M E L","family":"van Dam","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Maastricht University Medical Centre (MUMC), Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dirk","family":"Posthouwer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Maastricht University Medical Centre (MUMC), Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,2,11]]},"reference":[{"key":"2025082801314924000_2016.feb11_1.bcr2015213229.1","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2012.157"},{"key":"2025082801314924000_2016.feb11_1.bcr2015213229.2","first-page":"478","article-title":"A case of emphysematous cholecystitis managed by laparoscopic surgery","volume":"9","author":"Bouras","year":"2005","journal-title":"JSLS"},{"key":"2025082801314924000_2016.feb11_1.bcr2015213229.3","first-page":"184","article-title":"Clinical images: emphysematous cholecystitis","volume":"10","author":"Carrascosa","year":"2012","journal-title":"CMAJ"},{"key":"2025082801314924000_2016.feb11_1.bcr2015213229.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMicm063675"},{"key":"2025082801314924000_2016.feb11_1.bcr2015213229.5","unstructured":"Zakko SF , Afdhal NH , Chopra S , et al . Acute cholecystitis: pathogenesis, clinical features and diagnosis. UpToDate Chopra S (Ed). http:\/\/www.uptodate.com\/contents\/acute-cholecystitis-pathogenesis-clinical-features-and-diagnosis?source=search_result&search=acute+cholecystitis&selectedTitle=1~67#H249918905. Accessed December 2015."},{"key":"2025082801314924000_2016.feb11_1.bcr2015213229.6","doi-asserted-by":"publisher","DOI":"10.1093\/jscr\/rju027"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2015-213229","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T08:31:56Z","timestamp":1756369916000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2015-213229"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,2,11]]},"references-count":6,"alternative-id":["10.1136\/bcr-2015-213229"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2015-213229","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,2,11]]}}}