Emphysematous cholecystitis is an uncommon presentation of cholecystitis that typically occurs in elderly male patients with diabetes. It has a higher mortality than calculous cholecystitis and often presents with insidious symptoms that lead to sudden deterioration. Though ultrasound is the preferred initial imaging modality for diagnosis, computed tomography is better in some cases due to the ability to visualize both air and complications of emphysematous changes. Once diagnosis is confirmed, management is either operative or percutaneous drainage, based on comorbid disease and complications.
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