[Gallbladder perforation in an autopsy sample]

Evaluation of 135 post-mortem reports over a period from 1953 to 1985 showed that 107 patients without adequate therapy for peritonitis had died of gallbladder perforation within 32 hours from surgery. Another 28 had died of gallbladder perforation following cholecystectomy. Forty patients had been hospitalised in moribund condition and died within 24 hours from admission. Three patients died of the consequences of undetected postoperative or posttraumatic cholecystitis, while another five died following appendectomy or herniotomy, after destructive cholecystitis in them had escaped detection. Cholecystectomy was performed on 28 patients for perforated destructive cholecystitis, and 25 of these died of peritonitis within 32 hours. Bronchopneumonia was the major cause of death of two patients and purulent cholangitis in a third case. Once early operation for acute cholecystitis had been introduced in 1965, no single patient was recordable from the post-mortem documentation who had died of the sequels of untreated gallbladder perforation below the age of 60.