Hepatobiliary and pancreatic surgery: emphysematous cholecystitis: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Hepatobiliary and pancreatic surgery: emphysematous cholecystitis

Sample item

A 65-year-old man with diabetes has right upper quadrant pain and sepsis. CT shows gas within the gallbladder wall and lumen. Which gas-forming anaerobe is characteristically implicated?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Clostridium perfringens

Emphysematous cholecystitis occurs mainly in diabetic patients with vascular compromise of the gallbladder. Gas-forming organisms such as Clostridium perfringens and Escherichia coli are found. The risk of gangrene and perforation is high, so urgent cholecystectomy or drainage with antibiotics is needed.

Option by option

  • A. Enterococcus faecalis

    Enterococci are common biliary organisms but do not typically form gas.

  • B. Salmonella typhi

    Salmonella typhi is associated with chronic carriage in the gallbladder and not with gas formation.

  • C. Clostridium perfringens (correct)

    Correct. Clostridium species are the classic gas-producing anaerobes in this condition.

  • D. Staphylococcus aureus

    Staphylococcus aureus does not characteristically produce intramural gas.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is C, Clostridium perfringens. Emphysematous cholecystitis occurs mainly in diabetic patients with vascular compromise of the gallbladder.

Why is "Enterococcus faecalis" not the answer?

Enterococci are common biliary organisms but do not typically form gas.

Why is "Salmonella typhi" not the answer?

Salmonella typhi is associated with chronic carriage in the gallbladder and not with gas formation.

Why is "Staphylococcus aureus" not the answer?

Staphylococcus aureus does not characteristically produce intramural gas.

What concept does this question test?

It tests Hepatobiliary and pancreatic surgery: emphysematous cholecystitis in General Surgery. Gas-forming organisms such as Clostridium perfringens and Escherichia coli are found. The risk of gangrene and perforation is high, so urgent cholecystectomy or drainage with antibiotics is needed.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Hepatobiliary and pancreatic surgery: emphysematous cholecystitis?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.