Article Text
Summary
Perforation of the gall bladder can occur due to a complication of acute (in 3%–10%) or chronic cholecystitis, presenting with or without gallstones. Other causes include trauma, neoplasms, steroid therapy or vascular compromise. In 1934, Niemeier classified the condition into three types: type I, acute perforation into the free peritoneal cavity; type II, subacute perforation with abscess formation; and type III, chronic perforation with fistula formation between the gall bladder and another viscus with type I experiencing the highest mortality rate. In particular, there are very few cases of gall bladder perforation associated with ischaemic bowel disease. We present a case of type I gall bladder perforation in a 70-year-old woman, without any apparent comorbidities, presenting with acute abdomen consistent with perforated duodenal ulcer with pneumoperitoneum on a plain abdominal radiograph and contrast-enhanced CT with eventual discovery of fundal perforation and ischaemic small bowel at laparotomy.
- gastrointestinal surgery
- pancreas and biliary tract
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Footnotes
Contributors NW, OKM and VV contributed equally to the manuscript formation.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent Next of kin consent obtained.
Provenance and peer review Not commissioned; externally peer reviewed.