Case series of spontaneous gall bladder perforation and review of literature

Abstract

Gall bladder perforation in acalculus cholecystitis is a rare condition and has a high mortality rate. A diagnosis before surgery is often difficult. We present two cases of gall bladder perforation encountered at an initial presentation without any clear radiological evidence. A 45 year old male patient, presented with chief complaints of diffuse abdominal pain since 1 day. No other complaints/symptoms were found on a detailed history. Exploratory Laparotomy of this patient, revealed a ruptured gall bladder with necrotic patches and approximately 3 litres of bilious fluid in the peritoneal cavity. Another 45 year old Female, known diabetic, hypertensive and asthmatic presented with diffuse abdominal pain. On laparotomy 2.5 litres of biloma with necrotic gall bladder was observed. Owing to rarity of gall bladder perforation, the condition is often misdiagnosed. Early diagnosis and immediate surgical intervention are the gold standard for decreasing the morbidity and mortality associated with perforation.