Perforated Cholecystitis
Perforated cholecystitis is a severe form of acute cholecystitis when it is not identified and treated early. When the gallbladder becomes more swollen, the blood supply to the gallbladder gets cut off, and it turns gangrenous. The gallbladder wall will burst due to the build-up fluid and pressure within it, and the bile from the gallbladder will escape from the gallbladder into the abdominal cavity.
If left untreated, perforated cholecystitis can lead to various other medical complications, such as:
- Bile peritonitis
- Hepatic/subhepatic/pelvic abscess formation
- Pneumonia
- Sepsis or septic shock
- Acute renal failure
Symptoms:
The pain for perforated cholecystitis is usually located at the right upper abdomen when the bile leakage is limited to the right upper abdomen. However, when the bile leakage has escaped to the entire abdomen, a patient can experience generalised pain all over the abdomen.
Treatment:
CT scan is a common imaging tool to help to diagnose this condition. Treatment for a perforated gallbladder will also be more complex. A more extensive surgery with laparotomy will be needed to clean up the bile that leaks to the other part of the abdominal cavity. I.e., the standard laparoscopic cholecystectomy may not be sufficient to treat the patient’s problem.
If a patient is not suitable to undergo surgery at presentation due to severe sepsis or an underlying medical condition, treatment with antibiotics will be initiated, and tube drainage to drain out the collection will be arranged. The patient will be offered to undergo surgery to remove the gallbladder when the medical condition is optimised.
