Perforated gallbladder

Case contributed by Aliakbar Sahraei
Diagnosis certain


Right upper quadrant pain, tenderness ,and vomiting for 3 days.

Patient Data

Age: 90-95 years
Gender: Female

Perforated gallbladder


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 the peritoneal cavity.

Multiple renal cysts, bilaterally.

Case Discussion

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.

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