Spontaneous perforation of gallbladder with intrahepatic biloma formation: sonographic signs and correlation with computed tomography

Abstract

Spontaneous perforation of gallbladder is a severe and infrequent complication of acute cholecystitis that requires early and accurate diagnosis. Concomitant development of intrahepatic collections is rarely observed in such cases. The present report emphasizes the relevance of imaging studies in this setting, describing the typical sonographic and tomographic findings for the diagnosis of such condition.

Intrahepatic perforation of the gallbladder causing liver abscesses: case studies and literature review of a rare complication

“…The intrahepatic nature of the gallbladder perforation can lead to difficulties in laparoscopic cholecystectomy, with a high prevalence of conversion to an open cholecystectomy. [12][13] However, initial management of pyogenic liver abscesses is antibiotic therapy and percutaneous drainage, especially in abscesses of biliary origin because they often fail to respond to medical therapy (as in our case). 14 However, in type-III gallbladder perforations, a cholecystectomy may be difficult and additional surgical procedures (eg fistulae repair) may be required.…”

Biloma: An Unusual Complication in a Patient With Calculus Cholecystitis

“…8 The pathophysiology leading to gallbladder perforation include cystic duct obstruction, stasis of bile that leads to increase in the intravesicular pressure, gallbladder dilatation and eventually perforation. 7,9 Niemeier classified gallbladder perforation into acute (Type I), subacute (TypeII) and chronic (Type III). In type I perforation there is generalized peritonitis, in subacute (Type II) there is localized peritonitis or pericholecystic abscess, and in chronic (Type III) there is a cholecystoenteric fistula.…”

“…However Intraheptic bilomas due to gallbladder perforation is rare. 9 Overlapping symptoms can be seen in both complicated and uncomplicated cholecystitis which make early diagnosis difficult but have important implications for patient management. Complicated cases need open cholecystectomy rather than laparoscopic cholecystectomy.…”

Gall bladder perforation along the abdominal wall: An unusual picture

“…Mural defects are readily visualized on CECT and MRI, as are mural thickening, accompanying collections/abscess, and inflammatory changes. Intramural air, which can be seen in emphysematous cholecystitis, is best visualized on CT [2][3][4][5]. CT, especially multislice CT, has been found to be the most accurate and sensitive imaging modality to detect GB perforations [5].…”