Gall Bladder Perforation: Still an Enigma in Tropics

Kundan, Meghraj; Chintamani,; Kumari, Anju

doi:10.1007/s12262-019-01869-5

Cited by 6 publications

(5 citation statements)

References 11 publications

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“…Isolated case reports of cholecystopleural fistula have been previously reported. 5,7,8 Similarly to this case, these cases were elderly patients who presented spontaneous dyspnea, pleural effusion, and identified E. Coli in their thoracentesis. None of the patients presented fever before admission or reported gallbladder disease symptoms.…”

Section: Discussionmentioning

confidence: 60%

“…None of the patients presented fever before admission or reported gallbladder disease symptoms. 5,7,8 A possible etiopathogenetic origin of pleural pathologies must include an abdominal origin. A high specificity imaging study should be requested.…”

Section: Discussionmentioning

confidence: 99%

“…The diagnosis of type 1 GBP can also prove to be a challenge, as many are diagnosed intra-operatively, rather than pre-operatively, and in some cases, after major complications. 5 Lee at al reported a fistulous formation attributed to percutaneous transhepatic gallbladder drainage, which also questions the safety of the procedure. 6 In their case, the biliopleural fistula was managed conservatively with percutaneous pleural drainage, obtaining spontaneous fistula closure.…”

Section: Introductionmentioning

confidence: 99%

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Gallbladder perforation with cholecystopleural fistula: a case report

et al. 2021

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The cholelithiasis is a common pathology, however, if left untreated may cause a gallbladder perforation (GBP). This complication can include local or generalized biliary spillage, or a fistulous communication to an adjacent organ. We report a case of a patient with cholecystopleural fistula in a 71-year-old male. Complicated cholelithiasis presented fistulous GBP into the right pleura cavity, progressing into an empyema. The diagnosis was made preoperatively with computed tomography, and the patient was treated with a laparoscopic cholecystectomy, thoracostomy tube, and a biliopleural fistulectomy. The postsurgical outcome was satisfactory, with uneventful follow-up 3 weeks after.

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Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Gallbladder perforation with cholecystopleural fistula: a case report

et al. 2021

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“…5 Acute uncomplicated cholecystitis is more common in females whereas spontaneous GB perforation is more common in males. 6,16 Commonest age being 48-60 years. 2 GBP results most commonly due to persistent cystic duct occlusion by an impacted calculus causing a rise in intracholecystic pressure, epithelial injury, release of phospholipases, degradation of cell membranes and intense inflammatory reaction.…”

Section: Discussionmentioning

confidence: 99%

Different outcomes of spontaneous gall bladder perforation owing to timing of surgical intervention: report of 2 cases

Dakhani

Lamani

2020

Int Surg J

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Gall bladder perforation (GBP) is a rare life-threatening complication with a high mortality due to atypical clinical presentation and delay in diagnosis due to atypical clinical presentation. Case report 1, 70-year-old female presented with complaints of pain abdomen, vomiting and blackish pigmentation over abdomen since a week. She was in shock on presentation, with necrotic patch over abdomen and abscess collection at umbilicus. Ultrasound revealed GBP at fundus with thick collection in gastrohepatic recess with overlying abdominal wall cellulitis. CECT was not possible and the patient could not be taken for surgery due to unstable vitals and expired the next day. Case report 2, a 68-year-old male presented with complaints of pain abdomen over right side with vomiting. Abdomen was tender diffusely with guarding in right hypochondrium. Ultrasound showed distended gall bladder (GB) with multiple calculi. Magnetic resonance cholangiopancreatography (MRCP) showed a GBP at fundus with pericholecystic collection extending into hepatogastric recess. He underwent total cholecystectomy and post-operative period was uneventful. Acute cholecystitis has a perforation rate of 2-11% due to cystic duct obstruction, ischemia and necrosis. Our first patient had type-III GBP and was in shock and did not survive due to bad condition on arrival whereas the second patient had type-I GBP and underwent cholecystectomy without any complications. Type-I and type-II GBP as proposed by Niemeier have better outcomes compared to type-III. Rapid diagnosis and surgical intervention are very much necessary for reducing mortality as they rarely present with typical signs and symptoms of perforation.

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“…Recommendations need to be reviewed as more current studies are added to the available literature. Fistulous communication has not been studied in detail and may vary depending on the organ/cavity of communication[ 16 - 19 ]. This systematic review aims to gather and revise the available evidence regarding chronic GBP with fistulous communication, focusing on management, specifically the type of surgical intervention, timing, and complications.…”

Section: Introductionmentioning

confidence: 99%

Gallbladder perforation with fistulous communication

Quiroga‐Garza¹,

Alvarez‐Villalobos²,

Muñoz-Leija³

et al. 2023

World J Gastrointest Surg

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BACKGROUND The management of gallbladder perforation (GBP) with fistulous communication (Neimeier type I) is controversial. AIM To recommend management options for GBP with fistulous communication. METHODS A systematic review of studies describing the management of Neimeier type I GBP was performed according to the PRISMA guidelines. The search strategy was conducted in Scopus, Web of Science, MEDLINE, and EMBASE (May 2022). Data extraction was obtained for patient characteristics, type of intervention, days of hospitalization (DoH), complications, and site of fistulous communication. RESULTS A total of 54 patients (61% female) from case reports, series, and cohorts were included. The most frequent fistulous communication occurred in the abdominal wall. Patients from case reports/series had a similar proportion of complications between open cholecystectomy (OC) and laparoscopic cholecystectomy (LC) (28.6 vs 12.5; P = 0.569). Mortality was higher in OC (14.3 vs 0.0; P = 0.467) but this proportion was given by only one patient. DoH were higher in OC (mean 26.3 d vs 6.6 d). There was no clear association between higher rates of complications of a given intervention in cohorts, and no mortality was observed. CONCLUSION Surgeons must evaluate the advantages and disadvantages of the therapeutic options. OC and LC are adequate options for the surgical management of GBP, with no significant differences.

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Gall Bladder Perforation: Still an Enigma in Tropics

Cited by 6 publications

References 11 publications

Gallbladder perforation with cholecystopleural fistula: a case report

Gallbladder perforation with cholecystopleural fistula: a case report

Different outcomes of spontaneous gall bladder perforation owing to timing of surgical intervention: report of 2 cases

Gallbladder perforation with fistulous communication

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