Conservative management of type 2 gallbladder perforation in a child

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Interventional Radiology

Background:

• Gallbladder perforation (GBP) is a rare but severe complication of cholecystitis, often seen in critically ill patients with acalculous cholecystitis and enteric fever.
• Surgical intervention for GBP may not always be feasible in these high-risk patients.
• Percutaneous tube cholecystostomy (PTC) is an established intervention but typically serves as a prelude to interval cholecystectomy.

Observation:

• This case report details a pediatric patient with a perforated gallbladder.
• The child was managed conservatively with PTC as the primary treatment modality.
• Cholecystectomy was successfully avoided in this case.

Findings:

• Percutaneous tube cholecystostomy (PTC) proved to be a successful definitive treatment for gallbladder perforation in a pediatric patient.
• Conservative management with PTC eliminated the need for surgical gallbladder removal.
• Gallbladder functionality was confirmed post-treatment using a Tc99m-HIDA scan.

Implications:

• PTC can be considered a definitive treatment option for gallbladder perforation in select pediatric cases, particularly when surgery is contraindicated.
• This approach may help avoid cholecystectomy, reducing patient morbidity.
• Further research could explore the long-term outcomes and efficacy of PTC as a definitive treatment for pediatric gallbladder perforation.