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Perforation of the gallbladder: analysis of 19 cases
Insights
Gallbladder perforation complicates acute cholecystitis in nearly 4% of patients, particularly the elderly with comorbidities. Early cholecystectomy is crucial to prevent gangrene and perforation in high-risk individuals.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Acute cholecystitis is a common surgical emergency.
- Gallbladder perforation is a severe complication with significant morbidity and mortality.
- Elderly patients and those with comorbidities represent a vulnerable population for acute cholecystitis complications.
Abstract:
Perforation of the gallbladder occurred in 19 (3.8%) of 496 patients with acute cholecystitis treated at one hospital in an 8-year period. The average age of the 19 patients was 69 years and the female:male ratio was 3:2. Most had a history suggestive of gallbladder disease and most had coexisting cardiac, pulmonary, renal, nutritional or metabolic disease. The duration of the present illness was short, perforation occurring within 72 hours of the onset of symptoms in half the patients; the diagnosis was not suspected preoperatively in any. In the elderly patient with acute cholecystitis who has a long history of gallbladder disease, cholecystectomy should be performed early, before gangrene and perforation of the gallbladder can occur.