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Gallbladder perforation: A rare case report
Warsinggih1, Mudatsir1, Arham Arsyad1
1Division of Digestive, Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
International Journal of Surgery Case Reports
|February 15, 2023
Summary
Gallbladder perforation (GBP) is a rare surgical emergency. Prompt diagnosis and surgical intervention are crucial for patient survival and preventing severe complications.
Area of Science:
- Gastroenterology
- Surgical Pathology
- Emergency Medicine
Background:
- Gallbladder perforation (GBP) is a severe condition, often fatal if diagnosis is delayed.
- It complicates acute cholecystitis in 6-12% of cases, presenting with varied symptoms.
- Delayed diagnosis and missed presentations are common challenges in managing GBP.
Observation:
- A 68-year-old woman presented with a week of abdominal pain, initially localized then generalized.
- Physical examination revealed decreased bowel sounds, abdominal guarding, and tenderness.
- Laboratory tests showed leukocytosis and hyperglycemia; ultrasound indicated cholelithiasis and free fluid.
Findings:
- The patient was diagnosed with generalized peritonitis, cholelithiasis, and sepsis.
- Exploratory laparotomy revealed a perforated gallbladder with surrounding fibrin.
- A 10 mm perforation was identified at the gallbladder neck/cystic duct junction.
Implications:
- Early recognition and surgical management of GBP are vital to reduce morbidity and mortality.
- Surgeons must maintain a high index of suspicion for GBP in patients with acute abdominal pain.
- This case highlights the importance of timely diagnosis and intervention in potentially fatal conditions like gallbladder perforation.
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