Title: Spontaneous perforation of gallbladder and review of literature
Authors: Mubashar Akram, Sanjay K.Bhasin, Iram Shokat
DOI: https://dx.doi.org/10.18535/jmscr/v6i11.127
Abstract
Background: Spontaneous perforation of gall bladder is a rare entity with high mortality rate whenever there is diagnostic delay. Rupture of gallbladder in association with gallstones is infrequent and without gallstones, it’s even rare. Rarity of spontaneous gallbladder perforation often makes diagnosis difficult and delay will lead to increased mortality and morbidity. Gold standard for management of spontaneous gallbladder perforation is early diagnosis and immediate surgical intervention.
Aim: 1.To study the etiological factors and outcomes (in terms of morbidity & mortality, if any) associated with spontaneous gallbladder perforation.
Design and Place: This is a retrospective observational study which was carried out in 21(twenty one) patients admitted in Post Graduate Department of Surgery Government Medical College, Jammu over a period of 3 years w.e.f. October 2014 to October 2017.
Method: 21 patients with spontaneous gallbladder perforation were included in study.11 patients with free perforation of gall bladder underwent immediate surgery in emergency. 09 patients had gall bladder perforation with localized collection (biloma/abscess) and one patient had gall bladder rupture with cholecysto-duodenal fistula. Early Laparotomy with peritoneal lavage/abscess drainage (wherever present) and cholecystectomy was done.
Result: Of the 21 patients included in our study, gallstones were seen in 17 patients. 4 patients who had gall bladder perforation in the absence of gallstones were having other co-morbid conditions. Early intervention decreases complication rate and hospital stay in these patients. Mortality was seen in 2(9.52%) patients.
Conclusion: The best form of management in gall bladder perforation is early diagnosis and immediate surgical intervention.
Keywords: Gall bladder perforation, Acalculus Cholecystitis, Niemeir classification.
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