Acute gall bladder perforation--a dilemma in early diagnosis.

Ong, C. L.; Wong, Ting Hway; Rauff, A

doi:10.1136/gut.32.8.956

Cited by 72 publications

(53 citation statements)

References 8 publications

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“…8,12,18 Glenn and Moore in their study, reported a mortality rate of gallbladder perforation patients of 42%, while other studies reported that the mortality rates are decreased to 12%-16% owing to the developments in anesthesiology and intensive care conditions. 11,15,25 While in our study 14% mortality was observed.…”

Section: Surgical Procedures and Morbidities Of The Patientscontrasting

confidence: 39%

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Study of clinical profile and outcome of gall bladder perforations at a tertiary care centre from central India

Jain¹,

Kolla²,

Datey³

et al. 2016

Int Surg J

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INTRODUCTIONAmongst the diseases of the gall bladder calculous cholecystitis is the most common. Acute cholecystitis can get complicated and result in complications like empyema, gall stone ileus, cholecystoenteric fistula, emphysematous cholecystitis, gall bladder perforation and biliary peritonitis.1 Of these, gall bladder perforation (GBP) is an uncommon but life-threatening complication of acute cholecystitis, with a reported mortality rate of 12-42%. [2][3][4] Niemeier in 1934 has classified gall bladder perforations in three types as follows; Neimeir classification is still in use with minor modifications after so many years. The aetiology of the ABSTRACT Background: Amongst the diseases of gall bladder calculous cholecystitis is the most common. Acute cholecystitis can worsen and result in various complications. Gall bladder perforation leading to generalised peritonitis is a lethal complication. Methods: In this retrospective observational study we have reviewed 550 cases of acute cholecystitis who were admitted to our institution in 8 years i.e. from 2008 to 2015. Perforations due to other causes (trauma, iatrogenic causes, and carcinoma) were excluded. Niemeier classification was used to identify the patients. Direct-abdominal Xray series, abdominal ultrasound scanning (US), abdominal contrast-enhanced computerized tomography (CECT), routine blood cell count, and blood chemistry tests were performed. Results: Fourteen cases (2.5%) were found to have gall bladder perforations during the course of investigations and intraoperatively. Ten (71.42%) were females out of the total fourteen patients. Mean age was 65 years and presenting features on admission were nausea, vomiting, abdominal pain, fever and variable general condition. Aetiopathology of gall bladder perforation remains obscure till date. This clinical condition still remains a diagnostic as well as therapeutic challenge to surgeons. On detailed review of literature, we could not get few references, as the condition is uncommon. Conclusions: We have done this study to analyse the variable clinical presentation, correlation of non-invasive investigations and intraoperative findings and outcome in cases of gall bladder perforations so as to improve our further management of such cases.

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Section: Surgical Procedures and Morbidities Of The Patientscontrasting

confidence: 39%

“…8,12,14,15 Tanaka et al reported that only one patient had a concrete diagnosis preoperatively in their series of 9 patients. 16 The majority of GBP patients include those who undergo early surgery with the diagnosis of acute cholecystitis.…”

Section: Surgical Procedures and Morbidities Of The Patientsmentioning

confidence: 99%

Study of clinical profile and outcome of gall bladder perforations at a tertiary care centre from central India

Jain¹,

Kolla²,

Datey³

et al. 2016

Int Surg J

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“…[6][7][8][9] Neimeier classified gall bladder perforation in three categories. [2][3][4][5][6][7][8]  Type-1 (acute): free perforation with generalized peritonitis.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2016

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“…In patients who can sustain a laparotomy, the threshold for an early surgery should be low. 8,9 The mortality associated with GB perforation is quite high.…”

Section: Discussionmentioning

confidence: 99%

Gallbladder perforation in acute acalculous cholecystitis: an atypical manifestation of dengue fever

Deshmukh¹,

Rath

Naresh

2018

Int Surg J

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Among the atypical manifestations of dengue fever, comprising 15.8% of all cases, acalculous cholecystitis forms a small subset. Acalculous cholecystitis is managed conservatively in majority of cases and a chance of gall bladder perforation is low (2-18%). Management of gall bladder perforation in the scenario of Dengue is sometimes complicated by presence of thrombocytopenia and its complications thereof. Mortality associated with gall bladder perforation is relatively high. Gallbladder usually perforates at the fundus and is to be dealt with surgically if it doesn’t localize. Laparoscopic management of gall bladder perforation is feasible as calot’s is relatively virgin (as there is no calculous disease). Thorough peritoneal toileting is possible and a chance of intra-abdominal abscess in post-operative period is a mere speculation. Laparoscopic management results in early recovery and fewer wound complications and lesser hospital stay.

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Acute gall bladder perforation--a dilemma in early diagnosis.

Cited by 72 publications

References 8 publications

Study of clinical profile and outcome of gall bladder perforations at a tertiary care centre from central India

Study of clinical profile and outcome of gall bladder perforations at a tertiary care centre from central India

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

Gallbladder perforation in acute acalculous cholecystitis: an atypical manifestation of dengue fever

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