A 50-year-old chronic diabetic presents with severe abdominal pain, nausea, vomiting and fever. Abdominal imaging shows the following. What is the next best step in managing this patient?
Correct Answer: Emergency cholecystectomy
Description: Emphysematous cholecystitis is a life-threatening form of acute cholecystitis More commonly seen in patients with immunosuppression (diabetics) or vascular disease. Radiologically it shows a distended gallbladder with gas in the in the gallbladder wall and lumen (air-fluid levels may be seen). Treatment requires emergency cholecystectomy and broad-spectrum parenteral antibiotic therapy.
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