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Gallbaldder perforation causing a subcutaneous abscess
Evangelos Misiakos1, Ira Tzepi1, Ilias Brountzos2
1Third Department of Surgery, University of Athens, School of Medicine, Attikon University Hospital, Athens, Greece.
International Journal of Surgery Case Reports
|December 3, 2014
Summary
A rare case of gallbladder perforation led to a subcutaneous abscess in an elderly woman. Treatment involved abscess drainage and spontaneous gallstone passage via a cholecystoenteric fistula.
Area of Science:
- Gastroenterology
- Surgical Case Reports
Background:
- Gallbladder perforation is a rare complication, particularly in elderly, thin individuals.
- A case report details a large, round mass in the right hypochondrium of an 82-year-old woman.
Purpose of the Study:
- To report a rare case of gallbladder perforation resulting in a subcutaneous abscess.
- To highlight the diagnostic and management approach for such a condition.
Main Methods:
- Clinical presentation of an 82-year-old female with a palpable abdominal mass.
- Diagnostic imaging using abdominal computed tomography (CT) to identify the abscess and impacted gallstone.
- Intervention involving transcutaneous paracentesis for abscess drainage.
Main Results:
- Abdominal CT confirmed a gallbladder perforation with abscess formation and a gallstone impacted in Hartmann's pouch.
- The abscess was successfully treated with transcutaneous paracentesis.
- The impacted gallstone spontaneously passed into the gastrointestinal tract via a cholecystoenteric fistula without complications.
Conclusions:
- Gallbladder perforation can present as a subcutaneous abscess, especially in elderly, thin patients.
- Abscess drainage is the primary treatment modality.
- Spontaneous resolution of impacted gallstones through fistulas can occur.
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