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Gallbladder perforation. An imaging analysis.

B N Siskind¹, H B Hawkins, D C Cinti

¹Department of Diagnostic Imaging, Yale University, New Haven, Connecticut 06510.

Journal of Clinical Gastroenterology

|December 1, 1987

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Radiologic imaging accurately diagnosed gallbladder perforation in most patients. Advanced biliary imaging techniques improved the detection rate of this critical condition, aiding in timely diagnosis.

Area of Science:

Radiology
Gastroenterology
Abdominal Imaging

Background:

Gallbladder perforation is a serious complication requiring prompt diagnosis.
Accurate radiologic assessment is crucial for identifying perforation and guiding treatment.

Purpose of the Study:

To evaluate the diagnostic performance of various radiologic modalities in detecting gallbladder perforation.
To assess the accuracy of imaging in identifying free perforation versus contained abscesses.

Main Methods:

Retrospective review of radiologic studies (cholescintigraphy, cholangiography, ultrasonography, computed tomography, plain films) in 23 patients with confirmed gallbladder perforation.
Correlation of imaging findings with surgical or autopsy results.

Main Results:

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Cholescintigraphy and cholangiography showed extravasation in 7 patients, indicating free perforation or large loculation.
Ultrasonography and computed tomography detected extragallbladder fluid and abscesses in 16 patients, ranging from small collections to large phlegmonous masses.
Plain films suggested perforation with right upper quadrant masses and calcifications in some cases.

Conclusions:

Gallbladder perforation was diagnosed or suspected preoperatively in 10 patients and antemortem in 22 of 23 individuals.
Improved biliary imaging techniques contributed to a higher recognition rate of gallbladder perforation compared to previous reports.