Acute gall bladder perforation: case series over three years
DOI:
https://doi.org/10.18203/2349-2902.isj20164800Keywords:
Acute cholecystitis, Cholelithiasis, Gall bladder perforationAbstract
Background: Acute perforation of gall bladder is a life threatening condition. It is a complication of acute cholecystitis. This is not an uncommon condition and resembles acute cholecystitis in its presentation. If there is delay in diagnosis and management there is high morbidity and mortality. It should be diagnosed as early as possible for better prognosis.
Methods: This is a retrospective study wherein data of cholelithiasis, acute and chronic cholecystitis and perforated gall bladder from our hospital for the last three years 2014-2016 was collected. The clinical presentation, investigations routine and radiological, surgical and medical management was analysed.
Results: Total numbers of patients with chronic cholelithiasis were 3534, patients with acute cholecystitis were 133, and numbers of patients with gall bladder perforations were 22, making it 0.6% of gall bladder disease patients and 16.5% among patients with acute cholecystitis. TLC was invariably raised in all the cases. 12 out of 22 cases were managed conservatively while others underwent surgery. There was no mortality in the series.
Conclusions: Gall bladder perforation occurs in about two weeks or several weeks after episode of acute cholecystitis, the incidence of occurrence of perforation increases to four folds if there is delay in proper management of acute cholecystitis more than two days after the onset of symptoms. Clinical presentation varies from an acute generalized peritonitis to nonspecific abdominal symptoms and thus requires prompt diagnosis for better prognosis.Metrics
References
Niemier OW. Acute free perforation of the gallbladder. Ann Surg. 1934;99:922-4.
Roslyn JJ, Thompson JE, Darvin H, DenBesten L. Riak factors for gallbladder perforation. Am J Gastroenterol. 1987;82:636-40.
Schwartz’ Principles of surgey. 2015. Macgraw- Hill Education, F Charles Brunicardi; 2015;10:1305-20.
Clemente CD/ Gray’Anatomy. Philadelphia: Lea and Febiger; 1985:132.
Robbins, Cotran. Pathologic Basis of Diseases. Elsevier: Kumar, Abbas, Fausto, Aster; 2010:885.
Molmenti EP, Pinto PA , Klien J. Normal and variant arterial supply of the liver and gall bladder. Paediatr Transplant. 2003;7:80.
Scott-Conner CEH, Dawson DL. Operative anatomy. Philadelphia: JB Lippincott; 1993:388.
Woods CM, Mawe GM, Saccone GTP. The sphincter of Oddi: understanding its control and function. Neurogastroenterol Motil. 2005;17:(Suppl 1):31.
Yokohata K, Tanaka M. Cyclic motility of sphincter of Oddi. J Hepato-Biliary-Pancreatic Surg. 2000;7:178.
Klien AS, Lillemoe KD, Yeo CJ. Liver, biliary tract, and pancreas. In: O’ Leary JP, ed. Physiologic Basis of Surgery. Baltimore: Williams and Wilkins; 1996:441.
Felice PR, Trowbridge PE, Ferrara JJ. Evolving changes in the pathogenesis and treatment of the perforated gall bladder: a combined hospital study. Am J Surg. 1985;149:466-473.
Breen DJ, Nicholson AA. The clinical utility of spiral CT cholangiography. Clin Radiool. 2000;55:733.
Neimeier DW. Acute free perforation of gall bladder.Ann Surg 1934;99:922-44’
Sharma R, Mondal A, Sen IB, Sawroop K, Ravishanker L, Kashyap R. Spontaneous perforation of the gall bladder during infancy diagnosed on hepatobiliary imaging. Clin Nucl Med. 1997;22:759-69.
Sood BP, Kalra N, Gupta S, Sidhu R, Gulati M, Khandelwal N, et al. Role of sonography in the diagnosis in the gallbladder perforation. J Clin Ultrasound. 2002;30:270-4.
Sovia M, Pamilo M, Paivansalo M, Taavistasainen M, Surama I. Ultrasonography in acute gallbladder perforation. Acta Radiol. 1988;29:41-4.
Kim PN, Lee KS, Kim IY, Bae WK, Lee BH. Gallbladder perforation: comparison of US findings with CT. Abdomen Imaging. 1994;19:239-42.
Sood BP, Kalra N, Gupta S, Sidhu R, Gulati M, Khandelwal N, et al. Role of sonography in the diagnosis in the gallbladder perforation. J Clin Ultrasound. 2002;30:270-4.
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