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Acute emphysematous cholecystitis is a rare condition. Its preoperative diagnosis is based upon radiological studies which should include a film in the dorsal decubitus position, a lateral and a film in lateral decubitus with the ray horizontal. The presence of air within the gall bladder lumen; and in a part or all of the wall. Additional findings: the presence of air in the peribiliary space; the presence of gas within the biliary tract, rarely reported, is of special interest in the case reported here. Gangrenous cholecystitis must be differentiated essentially from: 1 degree an internal biliary fistula 2 degrees air in a neighbouring organ 3 degrees lipomatosis.
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