Emphysematous cholecystitis.

Emphysematous cholecystitis is an uncommon variant of acute cholecystitis, and a communication between biliary ducts and gastrointestinal tract should be evaluated. Making the diagnosis often is straightforward on plain abdominal radiography. Prompt diagnosis of emphysematous cholecystitis is critical, and the standard treatment is emergent cholecystectomy. In severely ill patients, percutaneous cholecystostomy with broad-spectrum antibiotics may be an alternative choice for treatment.