Diagnosis and treatment of gallbladder perforation.
OBJECTIVE
To present our clinical experience with gallbladder perforation cases.


METHODS
Records of 332 patients who received medical and/or surgical treatment with the diagnosis of acute cholecystitis in our clinic between 1997 and 2006 were reviewed retrospectively. Sixteen (4.8%) of those patients had gallbladder perforation. The parameters including age, gender, time from the onset of symptoms to the time of surgery, diagnostic procedures, surgical treatment, morbidity, and mortality were evaluated.


RESULTS
Seven patients had type I gallbladder perforation, 7 type II gallbladder perforation, and 2 type III gallbladder perforation according to Niemeier's classification. The patients underwent surgery after administration of intravenous electrolyte solutions, and were treated with analgesics and antibiotics within the first 36 h (mean 9 h) after admission. Two patients died of sepsis and multiple organ failure in the early postoperative period. Subhepatic abscess, pelvic abscess, pneumonia, pancreatitis, and acute renal failure were found in 6 patients.


CONCLUSIONS
Early diagnosis and emergency surgical treatment of gallbladder perforation are of crucial importance. Upper abdominal computerized tomography for acute cholecystitis patients may contribute to the preoperative diagnosis of gallbladder perforation.
Derici
Hayrullah
H
Third Surgical Clinic of Atatürk Training and Research Hospital, 156 sok. No. 5/13 Bornova, Izmir 35360, Turkey. hayrullahderici@yahoo.com
Kara
Cemal
C
Bozdag
Ali-Dogan
AD
Nazli
Okay
O
Tansug
Tugrul
T
Akca
Esra
E
D000368:Aged; D000369:Aged, 80 and over; D041881:Cholecystitis, Acute / Q000150:complications / Q000175:diagnosis / Q000473:pathology; D005260:Female; D005704:Gallbladder / Q000473:pathology / Q000601:surgery*; D005705:Gallbladder Diseases / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012422:Rupture, Spontaneous / Q000175:diagnosis / Q000209:etiology / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed