GALLBLADDER PERFORATION, THOUGH A RARE PRESENTATION OF ACUTE ABDOMEN NEEDS IMMEDIATE INTERVENTION AND UTMOST EXPERTISE IN ITS MANAGEMENT

Abstract

ABSTRACT- INTRODUCTION Gallbladder
perforation is an unusual presentation
that is rarely diagnosed preoperatively
in a case of acute abdomen.
It has a high mortality rate between 15-
45 percent because of delay in diagnosis.
Timely intervention by an expert surgical
team is the key in reducing morbidity
and mortality.AIM To stress the importance
of gallbladder perforation which
should always be borne in mind as one
of the differential diagnosis of acute abdomen
because timely and optimal intervention
saves the life of the patient.
METHODS We present a series of 8
cases of gallbladder perforation which
we encountered in our institution between
August 2009 to August 2011. All
cases presented with features of acute
abdomen.These patients were diagnosed
to have perforation based on their
clinical presentation. All the patients
were
taken up for emergency laparotomy. Open
cholecystectomy with peritoneal lavage
and drainage was performed. Patients
were given intensive post-op care, complications
when encountered were managed
accordingly.RESULTS All our patients presented
with clinical features suggestive of
perforative peritonitis The mean duration
between admission and surgery was
around 8 hrs. 6 had type I perforation and 2
had type II perforation with fundus being
the most common site affected. One patient
died of sepsis in the early post operative
period.CONCLUSION-An aggressively
oriented investigation strategm and surgical
treatment of gallbladder perforation are
of crucial importance in significantly reducing
the morbidity and mortality of this condition
which remained high throughout the
literature.