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Cholecystitis accounts for 3–10% of cases of abdominal pain worldwide. [43] Cholecystitis caused an estimated 651,829 emergency department visits and 389,180 hospital admissions in the US in 2012. [44] The 2012 US mortality rate was 0.7 per 100,000 people. [44] The frequency of cholecystitis is highest in people age 50–69 years old. [43]
Antibiotics alone are not effective because they may not penetrate infected tissues sufficiently. [30] Antibiotic treatment of gas gangrene, except for C. tertium infections which is treated with vancomycin or metronidazole intravenously, is typically penicillin and clindamycin for about two weeks. [31]
Severe infections typically require IV antibiotics that cover more pathogens, such as gram positive organisms, gram negative organisms, and obligate anaerobes to allow for better treatment outcomes. [4] Total antibiotic treatment of severe infections should be approximately 2–3 weeks or more, depending on how extensive the infection is. [5]
Antibiotics given intravenously such as cefuroxime and metronidazole may be administered early to help kill bacteria and thus reduce the spread of infection in the abdomen and postoperative complications in the abdomen or wound. Equivocal cases may become more difficult to assess with antibiotic treatment and benefit from serial examinations.
Risk factors for gas gangrene include severe injuries, abdominal surgeries, and underlying health conditions such as colon cancer, diseases of the blood vessels, diabetes, and diverticulitis. However, the most common way to get gas gangrene is through a traumatic injury. In the United States, there is only about 1000 cases of gas gangrene per year.
Only about 25 to 40% of bile duct injuries are detected intraoperatively. A biliary stricture, leak, or obstruction may be the injury's outward manifestation. A history of gallbladder empyema or gangrenous cholecystitis as reasons for cholecystectomy should raise the possibility of biliary injury. If the bile duct injury is not recognized right ...
Non-gangrenous ischemic colitis, which comprises the vast majority of cases, is associated with a mortality rate of approximately 6%. [34] However, the minority of patients who develop gangrene as a result of colonic ischemia have a mortality rate of 50–75% with surgical treatment; the mortality rate is almost 100% without surgical intervention.
Treatments involve antibiotics that cover for P. aeruginosa. Antipseudomonal penicillins, aminoglycosides, fluoroquinolones, third-generation cephalosporins, or ceftriaxone aztreonam can be given. Usually, the antibiotics are changed according to the culture and sensitivity results. [4]