Isolated Gallbladder Perforation Research Articles

Late presentation of isolated gallbladder perforation due to penetrating abdominal trauma. Case Report

Late presentation of isolated gallbladder perforation due to penetrating abdominal trauma. Case Report

Unusual presentation following blunt trauma abdomen: isolated gallbladder perforation

The gallbladder is a well-protected organ. Hence, injury to the gallbladder following blunt trauma is infrequent. The clinical presentation of gallbladder injury is variable, resulting in a delay in diagnosis and treatment. Isolated gallbladder perforation is a diagnosis of exclusion. Ultrasonography and contrast-enhanced CT are valuable assets in diagnosis. Cholecystectomy remains the procedure of choice. Mortality and morbidity is high in late presentations with biliary and bacterial peritonitis. It is thus necessary that the clinician be aware of this entity to have a high index of suspicion and to treat early.

Isolated gallbladder perforation in paediatric blunt abdominal injury: A case report and review of literature

Gallbladder injury in blunt abdominal trauma is rare, around 2% of all abdominal traumas. Vague symptoms and inconclusive imaging make it an elusive diagnosis, more so in children. Only 30 pediatric cases have been reported worldwide till date. We report a case of a 7yrs old boy presenting 2 weeks after a road accident with a gallbladder rupture which was eventually discovered on a diagnostic laparoscopy. This is the second such case being reported from India. The injury is most often identified at exploration and although cholecystectomy is the preferred treatment, there are occasions when the gallbladder may be left in situ. The classification system of Losanoff and Kjossev has merit in guiding treatment. The various presentations, mechanisms and modes of injury have been highlighted along with the clinical and imaging findings. Despite the developments in modern radiology, identifying gallbladder perforation has always been difficult because of the rarity of the condition. In a child with blunt abdominal trauma and intra-abdominal free fluid without any solid organ injury, a diagnostic peritoneal tap may be helpful. Based on the current evidence, we advocate a low threshold for performing a diagnostic laparoscopy in all such cases.

Isolated Gall Bladder Perforation in A Tertiary Care Hospital in Eastern Nepal: A Descriptive Cross-sectional Study

Introduction: Cholelithiasisis is a common surgical problem worldwide. Gall bladder perforation is a rare life-threatening complication with considerable mortality. This study aims to find the etiology, demography, type of perforation, and outcome of gall bladder perforation.
 Methods: This descriptive cross-sectional study was done on patients above 18 years of age visiting the department of surgery of B. P. Koirala Institute of Health Sciences (BPKIHS) who were diagnosed with isolated gall bladder perforation. The study was done from 1st January 2006 till 30 December 2016. Ethical approval was obtained from the Institutional Research Committee (reference number. 34/074/075). The convenient sampling method was used. Data were entered in excel sheets and analyzed.
 Results: Out of 49 patients included in the study, 28 (57.14%) were females and the commonest age group was 36 to 50 years 22 (44.9%) followed by 51 to 65 years 16 (32.6%). Most of the patients presented in emergency with pain in their abdomen. Diabetes mellitus was the commonest co-morbidity present in 10 (20.41%) patients. Operative management was done in 45 (91.84%) of the patient and conservative management in 4 (8.16%). After surgery of 45 patients, 43 (95.56%) improved and 2 (4.44%) expired. The most common type of perforation was Niemeier Type I in 21 (46.67%) followed by Type III 14 (31.11%). The most common histopathological diagnosis was acute cholecystitis 20 (44.44%).
 Conclusions: Isolated gall bladder perforation is not an uncommon complication. The most common etiological factor was acute cholecystitis with a slight female predominance. Most of the patients needed surgical intervention and they had good outcomes when diagnosed and managed on time.

Isolated gallbladder perforation following blunt abdominal trauma.

A 32-year-old man sustained an isolated perforation of the gallbladder following blunt abdominal trauma. A preoperative diagnosis was made on an ultrasound scan, which showed a pericholecystic fluid collection only. At laparotomy, a gallbladder perforation at the infundibulum was identified with a localised bile collection, warranting a cholecystectomy. Isolated gallbladder injury from blunt abdominal trauma is rare, and a high index of suspicion is required to establish the diagnosis. Cholecystectomy is the treatment of choice.

Isolated Gallbladder Perforation in Cases of Blunt Trauma Abdomen

Isolated perforation of gallbladder (GB) following blunt trauma abdomen is extremely rare and may pose a diagnostic challenge. Early diagnosis and treatment is of paramount importance to reduce morbidity and mortality associated with GB perforation. We present two cases of isolated GB perforation in patients of blunt abdominal trauma diagnosed on multi-detector computed tomography (MDCT) which was corroborated by bile stained peritoneal aspirate and subsequently confirmed by surgery. Both the patients underwent open cholecystectomy with good outcome.DOI: http://dx.doi.org/10.3126/njr.v3i2.9614 Nepalese Journal of Radiology Vol.3(2)July-Dec, 2013: 72-76

English

INTRODUCTION: Gall Bladder perforation with superior mesenteric artery thrombosis causing midgut gangrene are two different pathologies occurring in a patient at same time presenting as an acute abdomen is a rare case. There is no such case reported in the literature of these two different diseases occurring together at a time in a patient. Incidence of isolated Gall Bladder perforation is reported as 3 % in cases of acute cholecystitis with mortality ranging from 12 to 16%1. Superior mesenteric artery ischemia is due to sudden hypoperfusion of small intestine leading eventually to small bowel gangrene. Acute mesenteric ischemia is a lethal disease due to delay in diagnosis by virtue of its nonspecific clinical presentation. Incidence of both the pathologies in a single patient has not been documented till date, however awareness of condition with high index of suspicion and early intervention is needed as emphasized in our case.

Isolated gallbladder perforation after trivial abdominal trauma in a child: a case report and review of the literature

Gallbladder injury after blunt abdominal trauma is rare. Isolated gall bladder perforation due to blunt abdominal trauma is even rarer. The clinical presentation of gallbladder injury is variable resulting in delay in diagnosis and treatment .Early diagnosis is thus essential but still remains a challenge. We present a case of 12 year old child with isolated gall bladder perforation following trivial blunt trauma to the abdomen.

Isolated gallbladder perforation following blunt abdominal trauma: A missed diagnosis

This is a case of a 21-year-old man who presented with history of abdominal pain following blunt abdominal trauma. Although the initial ultrasound scan showed mild free peritoneal fluid, the patient was managed conservatively as a probable case of splenic injury and was discharged in satisfactory condition after 6 days of admission. He presented again 7 days later with recurring epigastric pain and had exploratory laparotomy on the presumptive diagnosis of peritonitis, probably due to peptic ulcer perforation. Intraoperatively, he was then discovered to have an isolated gallbladder perforation. This is a rare condition in which the diagnosis is often delayed or missed as was the case in our patient. To the best of our knowledge, this is the first reported case of isolated gallbladder perforation in Nigeria, and it behooves the clinician to be aware of the likelihood of this condition in patients with blunt abdominal injury.

Isolated gallbladder perforation after blunt abdominal trauma in children

Injury of the gallbladder after blunt abdominal trauma is rare. Isolated contusion of the gallbladder is exceptional because of its anatomical localization. It is protected by the liver, intestines, the omentum, and ribs. Its clinical presentation is often insidious, the reason why the diagnosis is often made during an exploring laparotomy. The delayed diagnosis is often responsible for high morbidity and mortality. The early diagnosis is thus essential but still remains a challenge. We report a case of isolated perforation of the gallbladder after blunt abdominal trauma in a 15-years-old boy found at the stage of generalized peritonitis. The exploratory laparotomy leads to diagnosis and treating the lesion by cholecystectomy.

Isolated Gall Bladder Perforation Following a Blunt Injury in the Abdomen

Gall bladder injuries which are caused after a blunt trauma in the abdomen are rare and they have significant mortality and morbidity when the treatment is delayed. They usually go undiagnosed until an exploratory laparotomy is done. We are reporting here a case of isolated gall bladder neck perforation, which is an uncommon finding following a blunt injury in the abdomen.

Isolated Gallbladder Perforation After Blunt Abdominal Trauma In Children: A Case Report.

Injury of the gallbladder after blunt abdominal trauma is rare. Isolated contusion of the gallbladder is exceptional because of its anatomical localization. It is protected by the liver, intestines, the omentum and ribs. Its clinical presentation is often insidious, the reason why the diagnosis is often made during an exploring laparotomy. The delayed diagnosis is often responsible of high morbidity and mortality. Early diagnosis is thus essential but still remains a challenge. We report a case of isolated perforation of the gallbladder after blunt abdominal trauma in a 15 years old boy found at the stage of generalized peritonitis. The exploratory laparotomy leads to diagnosis and treating the lesion by cholecystectomy.

Blunt Abdominal Trauma with Isolated Gallbladder Perforation Mimicking Acute Pancreatitis

Isolated gallbladder rupture following blunt abdominal trauma is rare. Presentation is quite variable and a delayed diagnosis is usually made at exploratory laparotomy. An interesting case is presented which mimicked acute pancreatitis. This case illustrates the need for close observation and a need for a high index of suspicion for intra-abdominal injuries in patients with blunt abdominal trauma.