Rodrigues ALS, Lobato MF, Braga CAR, Meguins LC, Rolo DF. Empyema with giant dilatation of the gallbladder. ABCD Arq Bras Cir Dig.2008;21(2):90-1 ABSTRACT -Introduction -Gallbladder empyema is a serious complication of acute cholecystitis being peritonitis and sepsis it´s main clinical consequences. Organ giant volume is rare specially with no relevant symptoms. Case report -Man 56-year-old with mild abdominal pain on the right hypochondrium, palpable gallbladder and ultrasound images revealing cholelithiasis. At surgery, there was a giant dilatation of the gallbladder with 580 mL of purulent bile. Cholecystectomy was carried out without post-operative complications. Conclusion -Early cholecystectomy should always be realized in patients presenting symptoms of gallbladder empyema no matter the size of it. hEADInGS -Empyema of the gallbladder. Cholecystectomy. Surgery. ABCD Arq Bras Cir Dig
BACKGROUND: Pneumoperitoneum is usually associated with a perforated peptic ulcer. However, perforated appendicits may be evolved on it. In the medical literature, the anatomo-radiologic correlation between them is an uncommon event. CASE REPORT: Man with 56-year-old look for assistance with diffuse abdominal pain and distension associated with fever, vomit and absence of flatus and evacuation for about 14 days. The chest radiography revealed a pneumoperitoneum. Diffuse peritonitis was found during the exploratory laparotomy. Appendectomy, peritoneal cavity cleaning and drainage with tubular drains were carried out. However, severe sepsis occurred and the patient died on the 16th post-operative day with multiple systemic organ failure. CONCLUSION: Although rare as pneumoperitoneum ethiology, acute appendicitis may be thought as it's cause.
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