Comparative Evaluation of Ultrasonography and Cross-sectional Imaging in Determining Gall Bladder Perforation in Accordance to Niemeier’s Classification

Boruah, Deb Kumar; Sanyal, Shantiranjan; Sharma, Barun Kumar; Boruah, D R

doi:10.7860/jcdr/2016/20158.8318

Cited by 8 publications

(5 citation statements)

References 13 publications

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“…CT could correctly diagnose all cases of types I and II GBP and this agrees with O'Connor et al [17]. In our study, we can see that there was a higher percentage of agreement between CT and operative findings with highest sensitivity and specificity of CT examination technique in this where the sensitivity and specificity were 100% and 100% compared to USG which indicates a slight agreement between the US examination technique and operative finding with lower sensitivity where the calculated sensitivity in this trial was 31.5% and this agrees with Boruah et al [18].…”

Section: Discussionsupporting

confidence: 91%

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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Section: Discussionsupporting

confidence: 91%

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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“…It is therefore advisable to perform a sonography followed by CECT in a suspected case of gall bladder perforation. MRCP is better at delineating the biliary tree and useful adjunct in diagnosing type 3 perforations (22). In the present study, a total of three (7.5%) patients died during the course of treatment, of whom two patients had type 1 gallbladder perforation and one had type 3 perforation.…”

Section: Discussionmentioning

confidence: 46%

A retrospective study of diagnosis and management of gallbladder perforation: 10-year experience from a tertiary health care centre

2023

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Objective: The aim of this study was to perform retrospective analysis of data collected from patients of gallbladder perforations for diagnosis, management and outcome. Material and Methods: A retrospective analysis of data was carried out for 40 patients of gallbladder perforations from the hospital record of patients who were diagnosed preoperatively and intraoperatively as a case of gallbladder perforation over a period of 10 years and were managed in our surgery unit of a tertiary health care centre. Patients were included irrespective of sex except cases of trauma and patients of the paediatric age group. Results: Among 40 patients, 26 were females and 14 were males. As per Anderson modification of Neimeier classification, 13 (32.5%) had type 1, 23 (57.5%) had type 2, and four (10%) patients had type 3 perforations and none of the patients had type 4 perforation. Twenty-three patients (57.5%) were found to have fundal perforation, followed by body in 11 patients (27.5%), three (7.5%) in Hartman’s pouch while in three patients (7.5%), there were multiple perforations. All patients of type 1 Neimer classification were diagnosed clinically as cases of biliary peritonitis, whereas most cases of type 2 Neimer classification were diagnosed preoperatively by CECT abdomen 12/23 patients (52%) and ultrasound abdomen 10/23 (43.47%). All patients underwent surgery, and there were three mortalities. Conclusion: In our study, there was female predominance in patients having gallbladder perforation. Of the patients, 52.5% were diabetic and mean age was 55.9 years. CECT abdomen was the most useful modality for diagnosis of type 2 gallbladder perforations. Timely surgical intervention is mandatory for a better outcome of these cases.

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“…Apart from providing early diagnosis, cross-sectional imaging also gives more accurate information regarding the location of collection and status of the gallbladder. [ 15 ] Rent in the gallbladder was detected in 14 of the 15 patients.…”

Section: Discussionmentioning

confidence: 99%

Early laparoscopic cholecystectomy in acute gallbladder perforation

Krishnamurthy

Ganesan

Ramas

et al. 2021

Journal of Minimal Access Surgery

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Background: Acute gallbladder perforation (GBP) is associated with significant mortality and morbidity. Percutaneous drainage followed by interval cholecystectomy has been the preferred management. The outcomes of early surgery, especially by laparoscopy, have not been well studied in GBP. We present our experience in early laparoscopic cholecystectomy in GBP. Methodology: A retrospective analysis of patients admitted with GBP between April 2014 and December 2018 was done. Clinical presentation, preoperative imaging, surgical procedure, operative findings and the outcomes in these patients were analysed. Video of the surgeries was reviewed in case of the absence of data from the case records. Results: Fifteen patients were treated for GBP during the study period. Eleven patients were male, and the mean age was 61 years. Fourteen patients (93.3%) had associated co-morbidities. Systemic inflammatory response syndrome, sepsis, severe sepsis and septic shock were present in 3, 3, 6 and 3 patients, respectively. The location of the collection was gallbladder fossa, pericholecystic, subhepatic and diffuse in 3, 5, 4 and 3 patients, respectively. Intraoperatively, 13 patients were detected to have perforation at the fundus of the gallbladder. Cystic duct stump was managed with clip, endoloop, suturing and external drainage in 7, 2, 5 and 1 patient, respectively. Laparoscopic cholecystectomy was completed in 12 (80%) patients. Retroinfundibular technique was used in 12 (80%) patients. There was one conversion. Two patients required endoscopic retrograde cholangiogram + bile duct stenting, and one was reexplored for cystic artery bleed. There were no mortalities. The median duration of post-operative hospital stay and drain removal was 3 (1–19) and 3 (1–6), respectively. Conclusion: Early laparoscopic cholecystectomy in acute GBP is feasible and can be safely performed in centres having sufficient expertise. Retroinfundibular technique of laparoscopic cholecystectomy is useful in tackling frozen Calot's triangle in GBP.

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Comparative Evaluation of Ultrasonography and Cross-sectional Imaging in Determining Gall Bladder Perforation in Accordance to Niemeier’s Classification

Cited by 8 publications

References 13 publications

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

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

A retrospective study of diagnosis and management of gallbladder perforation: 10-year experience from a tertiary health care centre

Early laparoscopic cholecystectomy in acute gallbladder perforation

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