Abstract
Emphysematous cholecystitis has a poor prognosis and necessitates prompt surgery or drainage. Emphysematous cholangitis (EC) is believed to have a similar clinical course, but reports are limited. We herein report the case of a 79-year-old woman who presented with epigastric pain and was diagnosed with EC. Rapid deterioration occurred after admission, requiring intensive and prolonged intravenous antibiotic therapy, despite immediate drainage and antibiotic therapy. We reviewed the background, causative organisms, treatment, and outcomes of EC through a literature search. Our findings provide insights into its similarities to emphysematous cholecystitis, emphasizing the need for expeditious drainage and anaerobic bacterial coverage during antibiotic therapy.