Delayed gallbladder rupture following percutaneous cholecystostomy.
Percutaneous cholecystostomy has become an accepted therapeutic alternative for high-risk patients with acute cholecystitis. However, some authors have cautioned that patients with gallbladder wall necrosis and gangrene may not be effectively treated by means of percutaneous drainage alone. A case is reported in which gallbladder wall necrosis progressed following technically successful percutaneous drainage. Spontaneous gallbladder rupture ensued, necessitating emergent cholecystectomy. Cholecystography 2 weeks following tube placement and 1 week prior to rupture showed a markedly abnormal, irregular gallbladder lumen. The authors suggest that follow-up cholecystography may be a useful tool for evaluating patient response to percutaneous cholecystostomy and for determining subsequent patient management.
LaBerge
J M
JM
Department of Radiology, University of California, San Fransisco 94143-0628.
Gordon
R L
RL
Kerlan
R K
RK
Ring
E J
EJ
D000208:Acute Disease; D002764:Cholecystitis / Q000601:surgery*; D002767:Cholecystostomy; D005705:Gallbladder Diseases / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012422:Rupture, Spontaneous; D013997:Time Factors