Abstract

Background: Perforation of the gall bladder due to choledocholithiasis is a rare cause of peritonitis. We present a case of gallbladder perforation and biliary peritonitis due to choledocholithiasis. Case report: A 50 years old male, without any known medical co-morbidity, presented with a 5-day history abdominal pain and distension. On abdominal examination, distension with rebound tenderness was present. MRI showed a gallbladder perforation. The patient was taken up for an emergency exploratory laparotomy which showed biliary peritonitis, perforation of gallbladder and choledocholithiasis. Cholecystectomyand choledocholithotomy done with T-tube placement. The patient's hospital course was uneventful except for the initial part when he required ventilator support and dialysis. Conclusion: Gallbladder perforation is an unusual initial presentation of gallbladder disease. Earlydiagnosis of gallbladder perforation and immediate surgical intervention are of prime importancein decreasing morbidity and mortality associated with this condition.

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