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Haemoperitoneum secondary to intrahepatic gallbladder perforation
D B Johnston1, G W Irwin2, E Epanomeritakis1
1Department of General Surgery, Craigavon Area Hospital, Portadown, UK.
A 70-year-old man experienced severe abdominal pain due to gallbladder perforation. Emergency surgery revealed massive internal bleeding, successfully treated with cholecystectomy.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- A 70-year-old male presented with right upper quadrant pain and nausea, initially diagnosed with cholecystitis.
- The patient's condition rapidly deteriorated with acute severe abdominal pain, tachycardia, and tachypnea.
Observation:
- Physical examination revealed peritonism in the upper abdomen.
- Computed tomography (CT) scan showed cholecystitis and pelvic fluid with Hounsfield units suggestive of blood.
Findings:
- Laparotomy revealed massive hemoperitoneum secondary to intrahepatic gallbladder perforation with a liver capsule tear.
- Cholecystectomy and liver packing achieved hemostasis.
Implications:
- This case highlights a rare but life-threatening complication of cholecystitis: gallbladder perforation with hemoperitoneum.
- Prompt diagnosis and surgical intervention are critical for managing such emergencies.
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