Presentation
We present a case of a novel, minimally invasive treatment, using endoscopic retrograde cholangiopancreatography to place a transcystic drain as a bridge to laparoscopic cholecystectomy. [ncbi.nlm.nih.gov]
present a case of 80 year old lady who presented to us as abscess of anterior abdominal wall. [casereports.in]
Entire Body System
- Asymptomatic
Our case highlighted some uncommon but severe complications which occurred simultaneously as the first manifestations of previously asymptomatic gallstone disease. [ncbi.nlm.nih.gov]
Spontaneous asymptomatic gallbladder perforation. Quant Imaging Med Surg. 2014 ;4(3): 212 - 3. doi: 10.3978/j.issn.2223-4292.2014.03.03 Google Scholar | Crossref | Medline 5. [doi.org]
Acute cholecystitis develops in up to 2% of patients affected by asymptomatic cholelithiasis. Gallbladder perforation occurs in 2 to 11% of acute cholecystitis cases. [wjes.biomedcentral.com]
- Anemia
Hematological investigations at the time of admission revealed anemia with hemoglobin level of 7.7gm/ dl and total leukocyte count of 8700/mm3. Plain X ray of the abdomen (erect view) did not show pneumoperitoneum. [tropicalgastro.com]
[…] biliary fistula 回虫症 ascaris lumbricoides 化学性胆嚢炎 chemical cholecystitis 化膿性胆管炎 pyogenic cholangitis オリエンタル胆管炎、再燃性胆管炎 oriental cholangiohepatitis, recurrent pyogenic cholangitis 化膿性胆嚢炎 purulent cholecystitis, cholecystitis purulenta 鎌状赤血球貧血 sickle cell anemia [jsge.or.jp]
- Congestive Heart Failure
We present a premature infant who had congestive heart failure and renal failure owing to complex congenital heart disease and developed gallbladder perforation at 60 days of age. [ncbi.nlm.nih.gov]
Cardiovascular
- Heart Disease
Two groups of patients are at increased risk for perforation: those with systemic diseases (especially peripheral vascular disease, intrinsic heart disease, or diabetes) and those who are chronically immunosuppressed. [ncbi.nlm.nih.gov]
[…] such as diabetes mellitus and atherosclerotic heart disease are predisposing factors. 4 Fundus is the most distal part with regards to blood supply and therefore this makes it the most common site for perforation which can occur as early as 2 weeks or [jpma.org.pk]
Infections, malignancy, trauma and drugs (e.g., corticosteroids) and systemic diseases such as diabetes mellitus and atherosclerotic heart disease are common predisposing factors. [3] Fundus, followed by the body, are the most distal part with regards [jiaps.com]
[…] such as diabetes mellitus and atherosclerotic heart disease are predisposing factors. [9] In our case, cholecystitis with obstructed biliary system due to choledocolithiasis seems to be the most probable etiology leading to raised intraluminal pressure [archintsurg.org]
Liver, Gall & Pancreas
- Jaundice
Jaundice as a sign of delayed gallbladder perforation following blunt abdominal trauma. Injury 1975;7:66-7. 9. Kao EY, Desser TS, Jeffrey RB. Sonographic diagnosis of traumatic gallbladder rupture. J Ultrasound Med 2002;21:1295-7. 10. [njcponline.com]
Al. [5] 10 day* Female Gastric outlet obstruction Not stated Gallbladder neck Cholecystostomy tube Shukla et al. [6] 4 month Male Acute abdomen Not stated Perforation ** Cholecystectomy Sharma et al. [7] 2 month Female Acholic stool, jaundice, abdominal [medcraveonline.com]
[…] as possible if you develop sudden and severe abdominal pain, particularly if it lasts longer than a few hours or is accompanied by other symptoms, such as jaundice and a fever. [nhs.uk]
We recently cared for a 65-year-old female with GBP who presented to us with a painful large anterior abdominal lump and jaundice. [archintsurg.org]
Signs of complications include high fever, shock and jaundice. [en.wikipedia.org]
Treatment
Conservative treatment of occult gallbladder perforation is possible and should be performed in high-risk patients. [ncbi.nlm.nih.gov]
Table 2 Factors determining a minimally invasive treatment Full table Conclusions Intrahepatic GBPs represent a rare complication of acute and chronic GB disease, which requires a rapid treatment in order to reduce the pathology-related high morbidity [hbsn.amegroups.com]
Prognosis
However, the correct and early diagnosis of gallbladder perforation is important for the treatment and prognosis. We report 4 critically ill patients with ascites. [ncbi.nlm.nih.gov]
Given that gallbladder perforation represents an advanced stage of acute cholecystitis, typically occurring in otherwise comorbid patients, the prognosis is often worse. [radiopaedia.org]
Prognosis is usually good; postoperative mortality has been minimal. [njcponline.com]
Perforated viscera in typhoid fever: A better prognosis for children. Journal of Pediatric Surgery 1975; 8: 531-532. [acmicrob.com]
An accurate and early diagnosis of GBP with liver abscess formation is important so as to start the treatment as soon as possible and thereby improve the prognosis. [scipedia.com]
Etiology
The etiology of gallbladder perforation varies greatly and is often unknown. Identified causes include infection, congenital, stones or choledochal cysts. [ncbi.nlm.nih.gov]
The etiology is not yet clear and further research is warranted. Multiple modalities have been used to assist in diagnosis yet most diagnoses are still made at the time of laparotomy. [medcraveonline.com]
[…] comprehensive investigation did not disclose any inflammatory/infectious condition (local or systemic) or biliary tract obstruction; moreover, the location of GP at infundibulum and absence of histologic signs of ischemia did not suggest a vascular etiology [journals.lww.com]
The choice of antibiotic is based on the organisms presumed to be involved (see Etiology ). Early in the course of the disease, good results are achieved with the adjuvant administration of a second-generation cephalosporin. [emedicine.medscape.com]
Epidemiology
Infectious Diseases: Epidemiology and Clinical Practice. 3rd ed. New York: Churchill Livingstone ; 1980. p. 47. 3. Kamble AT, Sarda DK, Chaudhary N, Hatwar S. Gall bladder perforation in typhoid fever. [tropicalgastro.com]
Radiology 264(3): 70–8 CrossRef Kimura Y, Takada T, Kawarada Y et al (2007) Definitions, pathophysiology, and epidemiology of acute cholangitis and cholecystitis: Tokyo Guidelines. [springermedizin.de]
"Definitions, pathophysiology, and epidemiology of acute cholangitis and cholecystitis: Tokyo Guidelines". Journal of Hepato-Biliary-Pancreatic Surgery. 14 (1): 15–26. doi : 10.1007/s00534-006-1152-y. ISSN 0944-1166. PMC 2784509. [en.wikipedia.org]
Pathophysiology
These patterns may provide pathophysiologic information for surgeon. [ncbi.nlm.nih.gov]
Sleisenger & Fordtran's Gastrointestinal and liver disease pathophysiology, diagnosis, management (9 ed.). [S.l.]: MD Consult. p. 1065. ISBN 9781437727678. [en.wikipedia.org]
Radiology 264(3): 70–8 CrossRef Kimura Y, Takada T, Kawarada Y et al (2007) Definitions, pathophysiology, and epidemiology of acute cholangitis and cholecystitis: Tokyo Guidelines. [springermedizin.de]
The pathophysiology of GBP may be caused by an inflammatory reaction and weakness of its wall in the course of the disease due to multiplication of S. Typhi in high numbers in the bile [ 3 ]. The intense inflammation caused by the highly virulent S. [acmicrob.com]
Acute acalculous cholecystitis associated with systemic sepsis and visceral arterial hypoperfusion: a case series and review of pathophysiology. Dig Dis Sci 2003; 48:1960. 36. Venkataramani A, Strong RM, Anderson DS, et al. [qq8oji.tokyo-med.ac.jp]
Prevention
Gallbladder (GB) perforation is a life-threatening complication of acute cholecystitis, and early diagnosis prevents delay in patient management. We present two cases of GB perforation diagnosed by color Doppler ultrasonography. [ncbi.nlm.nih.gov]