Spontaneous Gallbladder Perforation Research Articles

S2145 A Spontaneous Gallbladder Perforation Leading to Hepatic Fistula, Gallstone Spillage, and Hepatic Abscess

S2145 A Spontaneous Gallbladder Perforation Leading to Hepatic Fistula, Gallstone Spillage, and Hepatic Abscess

Spontaneous gallbladder perforation in a full-term neonate: A case report

Background: Spontaneous gall bladder perforation is an uncommon event among neonates. The etiology of perforated gall bladder in this pediatric age group is idiopathic. Only 9 cases are available in literature up till 2019. Case Presentation: We are reporting a case of spontaneous gall bladder perforation in a 15-day-old neonate who presented with vomiting, abdominal distension, and jaundice. The gall bladder was perforated near the fundus. Per-operative cholangiogram showed the normal passage of contrast. Open cholecystectomy was performed. No postoperative biliary complications were observed. Conclusion: Though Gall bladder perforation of spontaneous nature is rare but should be kept in the differential diagnosis in neonates who present with jaundice, abdominal distension, and acute abdomen.

Spontaneous acalculous gallbladder perforation mimicking duodenal stump leak after gastrectomy for gastric cancer: A case report.

Introduction and importanceSpontaneous gallbladder (GB) perforation is a rare and severe condition. Herein, we present a case of spontaneous acalculous gallbladder perforation mimicking duodenal stump leak after a subtotal gastrectomy for gastric cancer.Case presentationAn 83-year-old woman underwent a radical subtotal gastrectomy for advanced gastric cancer. On postoperative day 5, mild leukocytosis was observed. A computed tomography (CT) scan revealed a slightly distended non-thickened GB with minimal air and fluid collection near the duodenal stump, and fluid collection in the abdominal and pelvic cavities. We considered a duodenal stump leak. The effluent of the Barovac located in the abdominal cavity was serosanguinous and the patient was stable, thus we observed and continued using antibiotics. On day 13, the Barovac stopped functioning properly, so we replaced it with a percutaneous catheter drain (PCD) under ultrasonography guidance, aided by the Barovac tract. The PCD drained over 1000 cc of bile daily. On day 16, a follow-up CT showed an increased fluid collection in the abdominopelvic cavity. After comparing this with the previous CT, we rediagnosed as spontaneous GB perforation. An emergency cholecystectomy was performed. Postoperatively, the patient's condition returned to normal and antibiotic therapy continued until day 14. The patient recovered without other complications and was discharged on day 28.Clinical discussionSpontaneous GB perforation is a rare but serious complication immediately after gastrectomy which should be looked out for.ConclusionWe report a rare case of spontaneous GB perforation mimicking duodenal stump leak after radical subtotal gastrectomy in gastric cancer.

P042 Spontaneous gallbladder perforation: a rare complication of eosinophilic granulomatosis with polyangiitis

Abstract Background/Aims Gallbladder (GB) perforation is a serious clinical condition, caused by cholecystitis with or without cholelithiasis. Although there have been reports of bowel perforation in many cases of vasculitis, we report to the best of our knowledge, the first case of spontaneous gallbladder perforation following a diagnosis of EGPA. This alerts the clinician to a unique complication of EGPA. Methods A 48-year-old man presented initially to haematology with weight loss and marked eosinophilia, investigations (bone marrow aspirate and trephine, CT chest, abdomen and pelvis) at the time showed no evidence of haematological causes. Subsequently, he developed worsening weakness and paraesthesia of the upper and lower limbs, ongoing for 4 months. He had a background of asthma, and hay fever, which were well-controlled. On examination, he had progressive quadriparesis with extensive muscle wasting. His abdomen was soft non-tender, and he had no skin changes, although he later revealed a photograph of a vasculitic rash affecting the limbs when the symptoms initially presented. Results Laboratory findings revealed raised white blood cells of 46.9 (4-10 x109/L), raised eosinophils of 29.4 (0.01-0.5 x109/L), thrombocytosis of 757 (150-410 x109/L), raised CRP of 172 (0-10mg/L), raised IgE 179(<107 kU/L), and IgG 20.8(6-16 g/L). An extensive infectious screen was performed including HIV, and hepatitis (A-E), which were all negative. Vasculitic screen was negative for PR3 and MPO ANCA. However, nerve conduction studies showed evidence of confluent mononeuritis mimicking acute demyelinating sensory motor neuropathy. Following this, a CT scan was requested to exclude underlying neoplasms and infection which revealed a GB perforation with defect in the distended GB wall. He had no typical symptoms of cholecystitis, favouring an underlying gallbladder necrotizing vasculitis as the cause of GB perforation. The patient was commenced on IV cyclophosphamide and maintained on prednisolone, and azathioprine. A percutaneous cholecystostomy was inserted and immunosuppression continued with antibiotic cover. He had excellent response to therapy and his mobility improved following physiotherapy and rehabilitation. However, he continues to have significant residual weakness of the small muscles of his hand (median and ulnar nerve palsies). An MRCP was later requested, this revealed a contracted GB with no evidence of cholelithiasis or ongoing inflammation. He remained asymptomatic of GB perforation, and as a result, surgeons decided not to proceed with a cholecystectomy. Conclusion Gallbladder vasculitis (GV) can occur as a single organ vasculitis or as part of a systemic vasculitis. In the rare occasion of its occurrence, it mainly presents as symptoms of cholecystitis. Spontaneous GB perforation as a complication of GV has been noted in patients with other vasculitides like Henoch-Schonlein Purpura. However, this is the first report of a spontaneous gallbladder perforation in a patient with EGPA. Disclosure J. Ochogwu: None. A. Madathil: None. H. Mazin: None. D. Makkuni: None.

Spontaneous Gall Bladder Perforation Presenting as a Diagnostic Challenge: a Case Series

Spontaneous Gall Bladder Perforation Presenting as a Diagnostic Challenge: a Case Series

A Case report of Spontaneous Gallbladder Perforation in Durrës Hospital

Gallbladder perforation occurs very rarely. The most frequent causes of this complication are: acute calculous gangrenous cholecystitis, acalculous cholecystitis, but very rarely, perforation of the gallbladder may occur without obvious clinical and radiological signs of perforation of the gallbladder. Here I am describing the case of a 76-Year-old woman. The patient was presented to the Emergency Department of Durres regional hospital with the diagnosis: Acute generalized abdomen. The etiological diagnosis was established during the surgical intervention. This clinical case is rare, but it shows that this diagnosis should be taken into consideration by surgeons, in elderly patients who present acute generalized abdomen with unclear etiology in the preoperative period.

Spontaneous gallbladder perforation in patient with COVID-19—a case report and review of literature

The Coronavirus 2019 disease (COVID-19) originated in Wuhan in China in December 2019 has evolved over the past year in terms of its pathophysiology, clinical presentation, imaging manifestations and management strategies. Though COVID-19 is predominantly a pulmonary illness, it is now established to show widespread extra pulmonary involvement. Gastrointestinal manifestations of COVID-19 are also well known. COVID-19 infection presenting with the involvement of gallbladder is extremely rare in medical literature. Gallbladder perforation should be thought of in COVID-19 patients complaining of with acute abdomen in with acute cholecystitis.

An unusual case of type II spontaneous gallbladder perforation presenting as a right iliac fossa mass.

Spontaneous gallbladder perforation (GBP) is a very rare clinical condition which is mostly associated with calculous cholecystitis. Neoplastic growths at ampulla of Vater usually present with progressive symptoms and are rarely associated with GBP. Type II GBP presents as a localized collection and abscess formation at the site of the perforation, but unusual presentation can be found. Definitive diagnosis in elderly patients presenting with a mass in the right iliac fossa (RIF) region could be quite difficult due to the wide range of potential pathologies of the different anatomical organs present there. Here we discuss an unusual presentation of GBP secondary to periampullary growth presenting as a RIF mass. An 84-year-old female presented with a history of right side lower abdominal pain and fullness for a period of about a month. She also complained of dyspeptic symptoms for roughly the same duration. She underwent contrast enhanced computed tomography (CECT) of the abdomen as an initial investigation which revealed a collection in the RIF region from GBP, and a periampullary growth causing complete obstruction of the biliary tract. Ultrasound guided drainage of RIF collection followed by Endoscopic Retrograde Cholangio-Pancreaticogrphy (ERCP) and stenting of the common bile duct (CBD) was arranged as palliative treatment, since patient was unfit for major therapeutic intervention, i.e. pancreatico-duodenectomy. This case illustrates the importance of cross-sectional imaging in the evaluation of patients with RIF masses, especially when they are not in the typical age for appendicular masses, and also highlights the variety of unusual pathologies that could possibly give rise to such mass lesions.

Different outcomes of spontaneous gall bladder perforation owing to timing of surgical intervention: report of 2 cases

Gall bladder perforation (GBP) is a rare life-threatening complication with a high mortality due to atypical clinical presentation and delay in diagnosis due to atypical clinical presentation. Case report 1, 70-year-old female presented with complaints of pain abdomen, vomiting and blackish pigmentation over abdomen since a week. She was in shock on presentation, with necrotic patch over abdomen and abscess collection at umbilicus. Ultrasound revealed GBP at fundus with thick collection in gastrohepatic recess with overlying abdominal wall cellulitis. CECT was not possible and the patient could not be taken for surgery due to unstable vitals and expired the next day. Case report 2, a 68-year-old male presented with complaints of pain abdomen over right side with vomiting. Abdomen was tender diffusely with guarding in right hypochondrium. Ultrasound showed distended gall bladder (GB) with multiple calculi. Magnetic resonance cholangiopancreatography (MRCP) showed a GBP at fundus with pericholecystic collection extending into hepatogastric recess. He underwent total cholecystectomy and post-operative period was uneventful. Acute cholecystitis has a perforation rate of 2-11% due to cystic duct obstruction, ischemia and necrosis. Our first patient had type-III GBP and was in shock and did not survive due to bad condition on arrival whereas the second patient had type-I GBP and underwent cholecystectomy without any complications. Type-I and type-II GBP as proposed by Niemeier have better outcomes compared to type-III. Rapid diagnosis and surgical intervention are very much necessary for reducing mortality as they rarely present with typical signs and symptoms of perforation.

Spontaneous Healthy Gallbladder Perforation, Case Report and Literature Review

<p>La perforación espontánea de la vesícula biliar es una entidad poco común y está relacionada principalmente con la colecistitis alitiásica; sin embargo, tiene una alta tasa de mortalidad en comparación con las muertes causadas por colecistitis litiásica, que solo representan 1%. Los datos clínicos y paraclínicos no son específicos, por lo que el diagnóstico oportuno es importante para proporcionar un tratamiento inmediato y evitar complicaciones con el propósito de mejorar el pronóstico del paciente.</p>

Rotura espontánea de vesícula biliar sana, reporte de caso y revisión de literatura

<p>La perforación espontánea de la vesícula biliar es una entidad poco común y está relacionada principalmente con la colecistitis alitiásica; sin embargo, tiene una alta tasa de mortalidad en comparación con las muertes causadas por colecistitis litiásica, que solo representan 1%. Los datos clínicos y paraclínicos no son específicos, por lo que el diagnóstico oportuno es importante para proporcionar un tratamiento inmediato y evitar complicaciones con el propósito de mejorar el pronóstico del paciente.</p>

Spontaneous perinatal gallbladder perforation

Spontaneous perinatal gallbladder perforation

A rare case of intrahepatic abscess secondary to spontaneous gallbladder perforation in a cancer patient treated by interventional radiology procedure

A rare case of intrahepatic abscess secondary to spontaneous gallbladder perforation in a cancer patient treated by interventional radiology procedure

Spontaneous gallbladder perforation occurring at neck in an 8-year old boy

Spontaneous gallbladder perforation (GBP) is a rare condition. Most of these perforations occur at the fundal region of the gallbladder. Perforation occurring at the neck of the gallbladder seems to be the rarest phenomenon. We herein describe a case of spontaneous GBP occurring at the neck of gallbladder in an 8-year-old boy, which was managed satisfactorily by surgical exploration and cholecystectomy.

Green dialysate and gallbladder perforation in a peritoneal dialysis patients: a case report and literature review

BackgroundGallbladder perforation is a rare but lethal condition and its diagnosis is usually difficult and delayed. Frequently, gallbladder rupture is associated with cholecystitis, but spontaneous perforation was ever described. However, spontaneous rupture of gallbladder has never been reported in patients underwent peritoneal dialysis.Case presentationWe report a 62-year-old man who presented with abdominal pain for 2 days to clinic. Peritoneal dialysis-related peritonitis was diagnosed initially. It was followed by spontaneous gallbladder perforation with greenish dialysate. The patient was managed successfully by antibiotic treatment and primary closure of gallbladder perforation with external drainage. He recovered from this critical condition and stayed on dialysis.ConclusionsEarly diagnosis and timely surgical intervention yields a good prognosis in PD patients with gallbladder perforation. Surgical intervention and antibiotic treatment are the mainstay of treatment. Both of them should take place promptly.

Spontaneous Gall Bladder Perforation: A rare clinical entity, a diagnostic and surgical challenge

Spontaneous Gall Bladder Perforation: A rare clinical entity, a diagnostic and surgical challenge

Spontaneous Gallbladdre Perforation: A case series

Background: Gallbladder is rarely injured as it is embedded in the liver and well protected by ribcage. Gallbladder perforation is a rare complication of acute calculus cholecystitis. Spontaneous gallbladder perforation is even rarer.Case Series: We present our experience of 4 cases of spontaneous gallbladder perforation. The patients were mostly males (3:1) with age ranging from 42-64 years. All the patients presented with abdominal pain, distension, ileus and fever ranging from 2-5 days duration. There was no prior history of biliary colic. Examination revealed abdominal tenderness and ileus. Abdominal radiographs showed multiple air-fluid levels and no pneumoperitoneum. Sonography and CT scan of abdomen revealed pericholecystic fluid, intra-abdominal collection with no evidence of gallstones. Provisional diagnosis was peritonitis in 3 and acute pancreatitis in one case. Image guided abdominal paracentesis yielded bilious fluid. In view of lack of clinical improvement and aspiration of bilious content all the patients were subjected to laparotomy. Gallbladder perforation in fundus region without stones and intra-abdominal bile collection was noted in all the patients. Cholecystectomy with peritoneal lavage and abdominal drainage was performed in all cases. Postoperative course was uneventful except wound infection in 2 cases. Histopathology report revealed features of acute cholecystitis in 2 and acute on chronic cholecystitis in the remaining 2 patients.Conclusion: Diagnosis of spontaneous gallbladder perforation should be suspected in middle aged patients who present with acute abdomen but does not have classical signs of peritonitis and in whom paracentesis has yielded bilious fluid.

Acalculous Cholecystitis with Spontaneous Gall Bladder Perforation in a Postoperative Case of Radical Cystectomy with Ileal Conduit

Acalculous Cholecystitis with Spontaneous Gall Bladder Perforation in a Postoperative Case of Radical Cystectomy with Ileal Conduit

Spontaneous Gallbladder Perforation in a Preterm Neonate

Spontaneous gallbladder perforation among the pediatric population is a rare occurrence. The authors present a 26 week gestation white male with a history of Spontaneous bowel perforation and repair that presented with recurrent pneumoperitoneum. The patient was found upon laparotomy to have a perforation at the gallbladder fundus which was treated with tube cholecystostomy. A review of the current literature is provided.

Case series of spontaneous gall bladder perforation and review of literature

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.