Patient presenting with right upper quadrant pain, tenderness and vomiting for 3 days.
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The gallbladder wall is disrupted and is in direct communication with a low-attenuation fluid collection tracking superiorly in a perihepatic distribution and inferiorly along the right paracolic gutter.
The gallbladder mucosa shows wall thickening and interrupted enhancement. Associated pericholecystic fat stranding extending to the porta hepatis. There is mild free fluid is seen in peritoneal cavity.
Multiple renal cysts, bilaterally.
2 case question available
Gallbladder perforation is a relatively rare complication that can occur in a number of situations, but occur most common as a result of acute cholecystitis. It carries a relatively high morality rate 1.
According to the Niemeier classification this case was a type I perforated gallbladder 2.
A cholecystectomy was performed for this patient immediately after the perforated gallbladder was seen. Despite the patient's age, 5 days after the operation the patient was discharged to home in very good condition.
- 1. Swayne LC, Filippone A. Gallbladder perforation: correlation of cholescintigraphic and sonographic findings with the Niemeier classification. J. Nucl. Med. 1990;31 (12): 1915-20. J. Nucl. Med. (link) - Pubmed citation