title: Management of gall bladder perforation evaluation on ultrasonography: report of six rare cases with review of literature.
abstract: BACKGROUND
  Perforation of the gall bladder with cholecystohepatic communication is a rare cause of liver abscess. We are reporting here six rare cases of gall bladder perforation with variable clinical presentations.
  
  
  METHODS
  Most patients presented with right hypochondrium pain and fever but two patients presented with only pain in the abdomen. Ultrasonography (USG) and Computed Tomography (CT) were used for diagnosis. The patients were also successfully treated.
  
  
  RESULTS
  There was a gall bladder perforation with cholecystohepatic communication, leading to liver abscess formation in most cases on USG and CT. The final diagnosis was confirmed on surgery.
  
  
  CONCLUSIONS
  The perforation of the gall bladder which leads to liver abscess is a rare complication of acute, chronic or empyema gall bladder. USG and CT scans are the most important diagnostic tool in diagnosing this rare complication. In the set up, where advanced options are not available, the only treatment of choice is the conservative one or surgery, according to the status of the patients.
authors.affiliation: Department of Surgery- Maharishi Markandeshwer Institute of Medical Sciences and Research, Mullana, (Distt-Ambala), Haryana, India. singalsurgery@yahoo.com
authors.forename: Rikki
authors.initials: R
authors.lastname: Singal
authors.forename: Amit
authors.initials: A
authors.lastname: Mittal
authors.forename: Samita
authors.initials: S
authors.lastname: Gupta
authors.forename: Bir
authors.initials: B
authors.lastname: Singh
authors.forename: Parul
authors.initials: P
authors.lastname: Jain
mesh_terms: D002764:Cholecystitis / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D010538:Peritonitis / Q000150:complications / Q000000981:diagnostic imaging; D011859:Radiography; D014463:Ultrasonography