title: Diagnosis and treatment of gallbladder perforation.
abstract: 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.
authors.affiliation: Third Surgical Clinic of Atatürk Training and Research Hospital, 156 sok. No. 5/13 Bornova, Izmir 35360, Turkey. hayrullahderici@yahoo.com
authors.forename: Hayrullah
authors.initials: H
authors.lastname: Derici
authors.forename: Cemal
authors.initials: C
authors.lastname: Kara
authors.forename: Ali-Dogan
authors.initials: AD
authors.lastname: Bozdag
authors.forename: Okay
authors.initials: O
authors.lastname: Nazli
authors.forename: Tugrul
authors.initials: T
authors.lastname: Tansug
authors.forename: Esra
authors.initials: E
authors.lastname: Akca
mesh_terms: 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