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Gallbladder perforation

Case contributed by Maulik S Patel
Diagnosis almost certain

Presentation

Diabetic female presented with right upper abdominal pain for last 2 days. There was a similar episode about 1 month back.

Patient Data

Age: 70 years
Gender: Female
ultrasound

Gallbladder shows diffuse wall edema. There is a breach in its wall with a tiny collection ( 2 - 3 cc ) in gallbladder fossa. There are multiple calculi in gallbladder lumen; largest measuring up to 11 mm. Gallbladder lumen is filled with echoes. The common bile duct is normal in caliber without any calculus. Intra-hepatic biliary radicles are not dilated. Pancreas and main pancreatic ducts are normal.

Case Discussion

Elderly diabetic female presented with the 2nd episode of right upper quadrant abdominal pain in last 4 wks. Ultrasound shows gallbladder calculi, cholecystitis, and gallbladder perforation. Surgery revealed calculi and pus in gallbladder lumen, sloughed wall, gallbladder wall perforation with a small peri-cholecystic collection.

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