Idiopathic perforation of the gallbladder: Report of a case and a review of the Japanese literature

Tanaka, Minoru; Takahashi, Hiroaki; Yajima, Yukihiro; Okamura, Kazunori; Kosaka, Atsushi; Mizumoto, Ryuji

doi:10.1007/bf00941814

Cited by 16 publications

(22 citation statements)

References 3 publications

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“…1,2 It is not possible to predict reliably in which patients this complication will develop. 8 Acute uncomplicated cholecystitis is more common among females, with a female to male ratio of two to one: However, GBP is more frequent in the male gender. 1,9,10 Study reported that there were a greater number of men than women with type I and type II perforations, as compared to those with type III perforations.…”

Section: Discussionmentioning

confidence: 99%

Gallbladder Perforation- Presenting as an Acute Abdomen

Gajendiraraj¹,

Ananthakrishnan²,

Balakrishnan³

2017

jemds

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BACKGROUNDGallbladder perforation is a rare but life-threatening complication of acute cholecystitis. About 2% to 15% of patients with acute cholecystitis may be complicated with perforation of gallbladder. It may present as an acute abdomen which is a rare presentation which requires an emergency intervention.The aim of the study is to emphasise the importance of gallbladder perforation as one among the differential diagnoses of cases presenting as acute abdomen.

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Section: Discussionmentioning

confidence: 99%

Gallbladder Perforation- Presenting as an Acute Abdomen

Gajendiraraj¹,

Ananthakrishnan²,

Balakrishnan³

2017

jemds

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“…In one review, a correct diagnosis was established preoperatively in only one of the nine (11.1%) patients. 7 The fundus is the most common site of perforation, probably because it is the most distal part with regards to blood supply. Furthermore, some systemic diseases, such as atherosclerotic heart disease, may induce ischemia of the gallbladder wall, leading to necrosis and perforation.…”

Section: Discussionmentioning

confidence: 99%

Idiopathic Perforation of the Gallbladder

A¹,

Baez-Giangreco²,

Afzal³

2000

Ann Saudi Med

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AB Abbad, A Baez-Giangreco, M Afzal, Idiopathic Perforation of the Gallbladder. 2000; 20(5-6): 417-418 Gallbladder perforation is an infrequent but potentially fatal disease. It is usually a complication of acute cholecystitis with or without gallstones and has rarely been reported in association with trauma, neoplasia, chemotherapy, vascular disease or pregnancy. [1][2][3][4][5][6] However, idiopathic perforation of the gallbladder without any demonstrable cause is an extremely rare occurrence, 7 and is the subject of this report. Case ReportA previously healthy 30-year-old Nepalese man presented to the emergency department of Dar Al-Shefa Hospital, Riyadh, as a result of two days' history of severe pain in the epigastrium, right hypochondrium and right lumbar region. The patient vomited once and had no urinary trouble. There was no history of trauma or drug abuse. His vital signs were as follows: pulse 99/min; blood pressure 140/100 mm Hg; respiration 24/min; and temperature 37.8°C. Physical examination revealed tenderness with rebound pain in the epigastrium, right upper quadrant and right lumbar region. Bowel sounds were faint, and no significant distention of the abdomen was noted. Laboratory studies revealed white blood cell count to be 18,500/mm 3 with predominance of neutrophils; hemoglobin 16 g/dL; hematocrit 43.8% and platelets 311,000/mm 3 ; SGPT 75 U/L (normal up to 42); SGOT 84 U/L (normal up to 37); alkaline phosphatase 166 U/L (normal up to 306); serum amylase 41 U/L (normal up to 90); BUN 11 mg/dL (normal 9-20); Na + 138 mmol/L (normal 135-155); and K + 3.5 mmol/L (normal 3.5-5.5). The Widal test, Sickling test and blood cultures were all negative. Urine analysis revealed no significant abnormality. The flat and upright abdominal radiographs were interpreted as suggestive of an adynamic ileus pattern and revealed no gas under the diaphragm. Ultrasonographic examination revealed a slight thickening of the gallbladder wall but no stones or distention. A small amount of free fluid was observed in the pelvis. With a provisional diagnosis of peritonitis secondary to perforated duodenal ulcer, acute cholecystitis or sub-hepatic retrocecal appendicitis, an emergency laparotomy was performed using a midline vertical incision about 12 hours after the admission and after initial hydration. The abdominal viscera were stained yellowish green. Bile was seen leaking through a small hole in the body of the gallbladder near the fundus. The gallbladder wall was slightly thickened, and it was neither distended nor inflamed. Other abdominal viscera were unremarkable. A small amount of bile-stained fluid was noted in the right paracolic gutter and pelvis. Bile culture was obtained and cholecystectomy was performed.

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“…Idiopathic and spontaneous perforation of acalculous gallbladder is very rare [1,2]. Mostly, gallbladder perforation is due to inflammation, trauma, or obstruction [3].…”

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confidence: 99%

“…Mostly, gallbladder perforation is due to inflammation, trauma, or obstruction [3]. Perforation of gallbladder can be classified into three groups: [1] Spontaneous, [2] Traumatic, and [3] iatrogenic. The spontaneous group is further sub-divided into an idiopathic group and a secondary group, which includes acute inflammation, infection, lithiasis, congenital obstruction, and anticoagulant therapy, etc.…”

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confidence: 99%

“…[2]. Causes of gallbladder perforation in acute cholecystitis are: [1] Bile stasis due to cystic duct obstruction, fasting, dehydration, and total parentral nutrition, which leads to a change in the bile content and concentration; [2] Vascular impairment of the gallbladder wall due to distention of the viscous, underlying systemic illness, such as sepsis, shock, atherosclerosis; and [3] Ischemic necrosis. As gallbladder perforation occurs most commonly at fundus due to least blood supply, this proves the importance of ischemic mechanism.…”

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confidence: 99%

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Spontaneous Perforation of Acalculous Gallblader: A Case Report

et al. 2011

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Main cause of gallbladder perforation is cholecystitis with or without stones. In old age, spontaneous perforation of gallbladder can be due to decreased blood supply which can be as the result of atherosclerosis, focal vasospasm or localized vasculitis. Perforation is associated with high morbidity and mortality if left untreated. Here, we report a rare case of idiopathic and spontaneous perforation of gallbladder in a 77 years old lady.

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Idiopathic perforation of the gallbladder: Report of a case and a review of the Japanese literature

Cited by 16 publications

References 3 publications

Gallbladder Perforation- Presenting as an Acute Abdomen

Gallbladder Perforation- Presenting as an Acute Abdomen

Idiopathic Perforation of the Gallbladder

Spontaneous Perforation of Acalculous Gallblader: A Case Report

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