Decoding the Enigma of Gallbladder Perforation: Exploring Patient Profiles, Diagnosis, and Step-Up Management...

Area of Science:

• Gastroenterology
• Surgical Gastroenterology
• Abdominal Surgery

Background:

• Gallbladder perforation (GBP) is a critical condition arising from acute cholecystitis, trauma, or gallstones.
• Nonspecific symptoms complicate early diagnosis, often mimicking other abdominal pathologies.
• This study examines clinical features, diagnosis, management, and outcomes of GBP at a tertiary center.

Purpose of the Study:

• To investigate the clinical features of gallbladder perforation.
• To evaluate diagnostic approaches and management strategies for GBP.
• To determine the outcomes of GBP in a tertiary care setting.

Main Methods:

• A retrospective cohort study included 72 adult patients diagnosed with GBP.
• Data collected included demographics, clinical presentation, diagnostic imaging (USG, CT), and treatment.
• Exclusion criteria were trauma and malignancy; data were analyzed retrospectively.

Main Results:

• The majority of patients were over 40 (73.9%) and female (67.1%).
• Right upper quadrant pain was the most common symptom (93%), with a mean presentation of 18.6 days.
• Conservative management (69.8%) and percutaneous drainage (16.6%) were common; overall mortality was 2.7%.

Conclusions:

• Gallbladder perforation presents with varied clinical signs; prompt diagnosis is vital.
• Percutaneous drainage is effective for non-resolving symptoms with collections, offering low morbidity.
• Multidisciplinary care is crucial for optimal GBP management, especially for complex cases.