Gall bladder perforation - is it still a diagnostic dilemma: a retrospective study

Nandyala, Venkat Narsimha Reddy; Pallam, Praveen; Chintakindi, Santosh Babu; Pallagani, Likiteshwar; Kundarapu, Gopikanth

doi:10.18203/2349-2902.isj20161131

Cited by 6 publications

(10 citation statements)

References 6 publications

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“…Out of 7 female cases, 5 were in the age group 61-65 years. This observation was slightly different from a study conducted by Nandyala VN et al 4 In their study, the commonest age group being affected was between 48-60 years with females being more affected within 38-48 years of age. A contradictory finding was seen in the study conducted by Derici H et al, were males were affected more than females with GBP.…”

Section: Discussioncontrasting

confidence: 94%

“…This is in agreement with various other similar studies. 4,6,7 The incidence of type II and type I GBP was found to be 58.3% and 41.6% respectively. Author did not come across any type III GBP during the study period.…”

Section: Discussionmentioning

confidence: 92%

“…6,7 This is in contrary to the study done by Nandyala VN et al, in which type I was more common than type II. 4 On clinical examination, most of the patients with type II GBP had guarding present in the right hypochondrium (n=4/7) and an USG finding of pericholecystic collection (n=6/7), whereas patients with type I GBP had diffuse guarding (n=3/5) and free fluid in the peritoneal cavity on USG (n=4/5).…”

Section: Discussionmentioning

confidence: 98%

“…Whereas in perforations involving the neck and the duct, the omentum usually seals off the perforation leading to localized peritonitis and pericholecystic fluid. 4 Patients with GBP usually present with features of peritonitis such as severe abdominal pain, vomiting, abdominal distension, constipation and fever. Many a times these features are indistinguishable from other causes of generalized peritonitis.…”

Section: Introductionmentioning

confidence: 99%

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Gall bladder perforation; occurrence, clinical presentation, diagnosis and their outcome: a retrospective study in a tertiary care hospital in South India

Ramachandra

Jabbar

2019

Int Surg J

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Background: Gall bladder perforation (GBP), is an uncommon complication of acute cholecystitis but it often remains a cause for diagnostic dilemma among surgeons while managing patients presenting with signs and symptoms of peritonitis. This study was undertaken to study the clinical profile of the patients diagnosed to have GBP which would aid in early diagnosis and surgical intervention thus improving the patient's outcome. Methods: A retrospective study from May 2013 to April 2018 with a sample size of 12 cases were studied. All cases were diagnosed either pre-operatively (based on radiological findings) or intra-operatively. Perforations of gall bladder caused due to trauma or iatrogenic reasons were excluded from the study. Intra-operative findings, postoperative sequelae and the outcome of the patient were evaluated. Results: The mean age of the patients was 66 and females were more affected than the males. USG done preoperatively could pick up only 1 out of 12 cases. Whereas CT showed gall bladder perforation in 3 out of 4 cases for whom CT was done giving it a sensitivity of 75%. Gall bladder perforation was commonly found to be located in the fundus followed by corpus and infundibulum. Conclusions: GBP is a rare complication of acute cholecystitis. It can present with full blown peritonitis features or vague abdominal symptoms. If promptly diagnosed and treated aggressively by laparotomy and cholecystectomy, the patient's outcomes are improved.

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Section: Discussioncontrasting

confidence: 94%

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Gall bladder perforation; occurrence, clinical presentation, diagnosis and their outcome: a retrospective study in a tertiary care hospital in South India

Ramachandra

Jabbar

2019

Int Surg J

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“…The incidence of gallbladder perforation in acute cholecystitis has been reported to range from 2 to 18%, and in between calculus and acalculous cholecystitis, the overall incidence of gallbladder perforation due to acalculous cholecystitis is higher (Fig. 1), reaching approximately 10 to 20% [5]. It is a rare but life-threatening event with mortality rates reaching 15% [6].…”

Section: Discussionmentioning

confidence: 99%

Role of MSCT in the diagnosis of perforated gall bladder (a retrospective study)

Harraz

Abou-Issa

2020

Egypt J Radiol Nucl Med

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Background: Although gall bladder perforation (GBP) is not common, it is considered a life-threating condition, and the possibility of occurrence in cases of acute cholecystitis must be considered. The aim of this study was to assess the role of multi-slice computed tomography (MSCT) in the assessment of GBP.Results: It is a retrospective study including 19 patients that had GBP out of 147, there were 11 females (57.8%) and 8 males (42.1%), aged 42 to 79 year (mean age 60) presented with acute abdomen or acute cholecystitis. All patients were examined with abdominal ultrasonography and contrast-enhanced abdominal MSCT after written informed consent was obtained from the patients. This study was between January and December 2018. Patients with contraindications to contrast-enhanced computed tomography (CT) (pregnancy, acute kidney failure, or allergy to iodinated contrast agents) who underwent US only were excluded. Patients with other diagnoses, such as acute diverticulitis of the right-sided colon or acute appendicitis, were excluded. The radiological findings were evaluated such as GB distention; stones; wall thickening, enhancement, and defect; pericholecystic free fluid or collection; enhancement of liver parenchyma; and air in the wall or lumen. All CT findings are compared with the surgical results. Our results revealed that the most important and diagnostic MSCT finding in GBP is a mural defect. Nineteen patients were proved surgically to have GBP.Conclusion: GBP is a rare but very serious condition and should be diagnosed and treated as soon as possible to decrease morbidity and mortality. The most accurate diagnostic tool is the CT, MSCT findings most specific and sensitive for the detection of GBP and its complications.

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Diagnostic utility of ultrasonography and computerized tomography in gall bladder perforation: A case report

Pun¹,

Karki²,

Shrestha

et al. 2020

Radiology Case Reports

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Gall bladder (GB) perforation can be misdiagnosed as any other more common cause of acute abdomen. We present a case of a 72-year-female who had presented to the emergency department with an acute abdomen. The clinical presentation and the biochemical markers had pointed towards acute pancreatitis. However, the ultrasonographic examination of the abdomen and the pelvis suggested GB perforation which was confirmed by the multislice computerized tomography scan. Following this the patient underwent open cholecystectomy and was successfully managed. The invaluable contributions from the radiological modalities led to the successful management of the patient.

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Gall bladder perforation - is it still a diagnostic dilemma: a retrospective study

Cited by 6 publications

References 6 publications

Gall bladder perforation; occurrence, clinical presentation, diagnosis and their outcome: a retrospective study in a tertiary care hospital in South India

Gall bladder perforation; occurrence, clinical presentation, diagnosis and their outcome: a retrospective study in a tertiary care hospital in South India

Role of MSCT in the diagnosis of perforated gall bladder (a retrospective study)

Diagnostic utility of ultrasonography and computerized tomography in gall bladder perforation: A case report

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