Visual diagnosis in emergency medicine| Volume 41, ISSUE 4, P400-401, October 2011

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Emphysematous Cholecystitis: Don't Be Lulled Into Complacency

      A 53-year-old man presented to our Emergency Department complaining of right upper quadrant pain and anorexia of 1 day's duration. He had no significant medical or surgical history. There was no history of diabetes mellitus. He was unaware of having any gallstones, and had no previous biliary symptoms. On presentation he was afebrile, with stable vital signs, but with a persistent sinus tachycardia of 120–130 beats/min. The right upper quadrant was tender to palpation with a positive Murphy's sign.
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