Gallbladder Perforation Presenting as Abdominal and Chest Wall Abscess

Varshney, Peeyush; Dhaked, Santosh K.; Gothwal, Sudarshan; Songra, Bhupen; Mathur, Shivank

doi:10.17659/01.2014.0001

Cited by 2 publications

(2 citation statements)

References 5 publications

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“…Radiological confirmation of the diagnosis is required, especially in cases of type II and III perforation. The atypical presentations of GBP like abdominal wall abscess as in our series and liver abscess has been reported in the literature [5][6][7][8][9][10][11][12] which can perplex the clinician due to its unusual presentation.…”

Section: Four Patients Underwent Laparoscopic Cholecystectomy and Sevmentioning

confidence: 88%

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Gallbladder Perforation: A Prospective Study of Its Divergent Appearance and Management

Patel

Jain

Kumar

et al. 2019

Euroasian Journal of Hepato-Gastroenterology

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Introduction: Gallstone disease is one of the most common surgical diseases. Complications associated with cholelithiasis is not uncommon, but gallbladder perforation is a rare complication of acute cholecystitis with cholelithiasis. This gallbladder perforation may present in different ways like free perforation inside peritoneal cavity causing generalized peritonitis, localized collection around gallbladder fossa after perforation and in chronic cases cholecystoenteric fistula. Here we present our experience of this condition with a review of literature for a different presentation of this condition. Materials and methods: This study was done for 2 years, and patients who were diagnosed with gallbladder perforation either preoperatively or intraoperatively were included. Results: There was a total of 16 patient included in the study during this period which were either diagnosed preoperatively or intraoperatively of gallbladder perforation (GBP). Conclusion: GBP, though a rare complication of cholecystitis with high morbidity and mortality, has no specific pathognomic feature and is often misdiagnosed or late diagnosed. Nowadays most cases can be managed with improved diagnostic means and therapeutic modalities (endoscopic, laparoscopic, endostaplers). IntroductIonG allbladder perforation (GBP) is a rare yet potentially fatal condition occurring as a complication of cholecystitis (calculous or acalculous). The clinical presentation of GBP may not be different from uncomplicated acute cholecystitis, or at times its presentation may perplex the clinician. The clinical features of GBP may vary from that of peritonitis to acute cholecystitis. The mortality rate of GBP is reported to be 12-16%. 1 Acute cholecystitis, calculus, or acalculous, can lead to GBP in 6-12% of cases. 2,3 There are many classifications proposed for GBP, but Niemeier classification is most commonly used. In 1934, he categorized GBP perforation in 3 types, type 1 (acute)-it manifests as generalized peritonitis, type 2 (subacute)-localization of fluid at the site of perforation with pericholecystic abscess and type 3 (chronic)-internal (bilio enteric) or external (cholecysto cutaneous) fistula. 4 Here we present our experience of this condition with variable presentation and poorly understood etiology, which is often diagnosed late resulting in high morbidity and mortality rate; dealt by us over a period of 2 years in our institute. The different clinical presentations and its management along with a brief review of the literature available are done in this study. MAterIAls A n d M e t h o d sThis study was done over a period of 2 years and patients who were diagnosed with gallbladder perforation either preoperatively or intraoperatively were included. The clinical presentation, demographic profile, investigations, and management done was recorded. The different possible etiological factors associated with GBP are also discussed. resultsThere was a total of 16 patient included in the study during this period which were either diagnosed preopera...

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Section: Four Patients Underwent Laparoscopic Cholecystectomy and Sevmentioning

confidence: 88%

“…Two patients had acute acalculous cholecystitis. There was male predominance over the female (10:6 ratio) and type 2 (7) perforation was seen more as compared to type 1 (5) and type 3 (4) ( Table 2). The youngest patient reported in our series was of age 17 years and the oldest was of age 80 years.…”

mentioning

confidence: 97%

Gallbladder Perforation: A Prospective Study of Its Divergent Appearance and Management

Patel

Jain

Kumar

et al. 2019

Euroasian Journal of Hepato-Gastroenterology

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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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Gallbladder Perforation Presenting as Abdominal and Chest Wall Abscess

Cited by 2 publications

References 5 publications

Gallbladder Perforation: A Prospective Study of Its Divergent Appearance and Management

Gallbladder Perforation: A Prospective Study of Its Divergent Appearance and Management

Gallbladder perforation with fistulous communication

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