Introduction: Gangrenous cholecystitis is a rapidly developing inflammation with necrosis of the gallbladder that is common in diabetic patients. Cholelithiasis, infections, and vascular causes are often involved. Without treatment, gallbladder gangrene perforates, a terrible and inevitable complication. 

The objective was to report a rare case of gangrenous cholecystitis leading to surgery. 

Clinical Case: It’s about a 26-year-old female patient presented with sudden onset of abdominal pain radiating to the back and right shoulder, accompanied by vomiting and fever for 3 days. 

History-taking revealed amenorrhea. 
Physical asthenia, anorexia, and fever were noted. Generalized guarding, more pronounced in the epigastrium and right hypochondrium, was observed. Murphy's examination was positive. Abdominal ultrasound revealed gallstoneinduced cholecystitis, peritoneal effusion, and an active pregnancy of 12 weeks of amenorrhea. 

Laparotomy revealed gallstone-induced peritonitis with multilithiasic gangrenous cholecystitis. Uterine enlargement was observed. 

We performed a cholecystectomy, abdominal lavage, and drainage. 

The postoperative course was uneventful. 

Conclusion: Gangrenous cholecystitis is rare, often late-onset, and recognized as serious. The fetal-maternal prognosis of our patient was favorable thanks to prompt and effective medical and surgical management.