Correct Answer : Emphysematous cholecystitis
The computed tomogram shows an air-fluid level in the lumen of a dilated gallbladder and gas within the gallbladder wall. These findings suggest emphysematous cholecystitis.
Cholelithiasis had previously been detected by abdominal ultrasonography. After drinking alcohol at home, the patient had acute abdominal pain. Plain-film radiography of the abdomen (Panel A) showed air (arrow) in the upper right quadrant. After antibiotic therapy, cholecystectomy and drainage were performed. Clostridium perfringens was isolated from the culture of drained biliary fluid. The patient recovered uneventfully.