This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Integrated QBank, Subject name: Unknown
A 50-year-old chronic diabetic presents with severe abdominal pain, nausea, vomiting and fever. Abdominal imaging shows the following. What is the next best step in managing this patient? 
Select and explain. 
A. Emergency cholecystectomy, B. ERCP, C. Observation for few days and repeat imaging, D. Elective cholecystectomy
A: Emergency cholecystectomy
Answer: A: Emergency cholecystectomy 
Explanation: Emphysematous cholecystitis is a life-threatening form of acute cholecystitis More commonly seen in patients with immunosuppression (diabetics) or vascular disease. Radiologically it shows a distended gallbladder with gas in the in the gallbladder wall and lumen (air-fluid levels may be seen). Treatment requires emergency cholecystectomy and broad-spectrum parenteral antibiotic therapy.