Gallbladder perforation: the hole sign

Abstract

We report a case of gallbladder perforation (GBP) in a patient with right upper quadrant pain and a positive Murphy's sign, a previous history of cholelithiasis and co-morbidities. We compare the diagnosis of GBP using the ‘hole-sign’ on ultrasound with the literature for contrast-enhanced ultrasound, computed tomography and magnetic resonance imaging.