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 spontaneou...

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Autores principales:	Sujit Kumar, Sanjay Negi, BN Patowary, Aditya Jalan, Sulabh Rajbhandari
Formato:	article
Lenguaje:	EN
Publicado:	Society of Surgeons of Nepal 2016
Materias:	Gallbladder perforation peritonitis spontaneous perforation Surgery RD1-811
Acceso en línea:	https://doaj.org/article/c6b54b01947440c4990f5d0a9122297c
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spelling	oai:doaj.org-article:c6b54b01947440c4990f5d0a9122297c2021-12-05T19:16:38ZSpontaneous Gallbladdre Perforation: A case series10.3126/jssn.v18i3.152941815-39842392-4772https://doaj.org/article/c6b54b01947440c4990f5d0a9122297c2016-07-01T00:00:00Zhttps://www.nepjol.info/index.php/JSSN/article/view/15294https://doaj.org/toc/1815-3984https://doaj.org/toc/2392-4772 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. Sujit KumarSanjay NegiBN PatowaryAditya JalanSulabh RajbhandariSociety of Surgeons of NepalarticleGallbladder perforationperitonitisspontaneous perforationSurgeryRD1-811ENJournal of Society of Surgeons of Nepal, Vol 18, Iss 3 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Gallbladder perforation peritonitis spontaneous perforation Surgery RD1-811
spellingShingle	Gallbladder perforation peritonitis spontaneous perforation Surgery RD1-811 Sujit Kumar Sanjay Negi BN Patowary Aditya Jalan Sulabh Rajbhandari Spontaneous Gallbladdre Perforation: A case series
description	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.
format	article
author	Sujit Kumar Sanjay Negi BN Patowary Aditya Jalan Sulabh Rajbhandari
author_facet	Sujit Kumar Sanjay Negi BN Patowary Aditya Jalan Sulabh Rajbhandari
author_sort	Sujit Kumar
title	Spontaneous Gallbladdre Perforation: A case series
title_short	Spontaneous Gallbladdre Perforation: A case series
title_full	Spontaneous Gallbladdre Perforation: A case series
title_fullStr	Spontaneous Gallbladdre Perforation: A case series
title_full_unstemmed	Spontaneous Gallbladdre Perforation: A case series
title_sort	spontaneous gallbladdre perforation: a case series
publisher	Society of Surgeons of Nepal
publishDate	2016
url	https://doaj.org/article/c6b54b01947440c4990f5d0a9122297c
work_keys_str_mv	AT sujitkumar spontaneousgallbladdreperforationacaseseries AT sanjaynegi spontaneousgallbladdreperforationacaseseries AT bnpatowary spontaneousgallbladdreperforationacaseseries AT adityajalan spontaneousgallbladdreperforationacaseseries AT sulabhrajbhandari spontaneousgallbladdreperforationacaseseries
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Spontaneous Gallbladdre Perforation: A case series

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