• Nannan Pan, WangShuoSDepartment of Orthopaedic Surgery, Tianjin Medical University Baodi Clinical College: Tianjin Baodi Hospital, Tianjin, China., and Zhenwei Miao.
• Department of Radiology, Tianjin Medical University Baodi Clinical College: Tianjin Baodi Hospital, Tianjin, China.
• Medicine (Baltimore). 2023 Jan 27; 102 (4): e32530e32530.

RationaleEmphysematous hepatitis (EH) is a rare and fulminant gas-forming liver infection. Only 3 patients were successfully treated. Diabetes mellitus and a history of digestive system cancer may predispose individuals to EH. Computed tomography (CT) findings support the diagnosis of EH and monitor progress.Patient ConcernsA 48-year-old man with diabetes presented with nausea, vomiting (gastric contents) and diarrhea. Laboratory test results revealed elevated levels of inflammatory indicators and abnormal liver function. CT showed a large-scale air collection with some remaining parenchymal debris in the left lobe of the liver. Remarkably, no fluid was observed inside the lesion.DiagnoseThe abdominal CT features and laboratory examination results rationalized the diagnosis of EH.Interventions And OutcomesThe patient finally recovered from this severe disease through a series of effective treatments, including strict glucose control, sensitive antibiotic therapy, and subsequent percutaneous drainage.LessonsEH generally deteriorates rapidly and eventually leads to death. This case will raise awareness of the rare and severe disease, strengthen diagnostic capacities, and provide advice to treat it.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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