Spontaneous gallbladder perforation in a child secondary to a gallbladder cyst: a rare presentation and review of literature

Abstract

Spontaneous gallbladder perforation is rare in children. The etiology of gallbladder perforation varies greatly and is often unknown. Identified causes include infection, congenital, stones or choledochal cysts. Presently there are only five reported cases of spontaneous gallbladder perforation in children in the English literature. As such, the optimal method of diagnosis and management remains controversial. We report the case of a 2-year-old girl who presented with peritonitis secondary to spontaneous gallbladder perforation.

Spontaneous acalculous gallbladder perforation in a man secondary to chemotherapy and radiation

“…Prior to laparotomy, we often have difficulty in diagnosing the gallbladder perforation. Patients with spontaneous perforation often present with biliary peritonitis [ 10 ] as we saw in the patient. The typical presentation includes fever, vomiting, abdominal pain, and sometimes shock.…”

Spontaneous Gallbladder Perforation in a Child With Anomalous Pancreaticobiliary Junction

“…The association with gallbladder perforation is never reported earlier. The previously reported causes of gallbladder perforation are calculous or acalculous cholecystitis, trauma, typhoid infection, or idiopathic 4–7 . Raised intraluminal pressure in the bile duct due to protein plugs in APBJ has been invoked in the etiopathogenesis of biliary perforation 8 .…”

“…The previously reported causes of gallbladder perforation are calculous or acalculous cholecystitis, trauma, typhoid infection, or idiopathic. [4][5][6][7] Raised intraluminal pressure in the bile duct due to protein plugs in APBJ has been invoked in the etiopathogenesis of biliary perforation. 8 We hypothesize that raised intraluminal pressure may also predispose to spontaneous gallbladder perforation.…”

“…Preoperative diagnosis is often missed, thereby increasing the morbidity and mortality associated with this condition. [4][5][6][7] Ultrasound frequently shows fluid collection in the peritoneal cavity with thickened wall. It may also directly show the defect in the gallbladder wall.…”

“…9 Management of a gallbladder perforation in the absence of APBJ is done by cholecystostomy or cholecystectomy. [4][5][6][7] However, treatment in presence of APBJ requires cholecystectomy with bile duct excision. 1 Therefore, knowledge of their association is important from management perspective.…”