Gangrenous cholecystitis as an incidental finding during emergency laparotomies for acute abdomen at a tertiary centre: a case series
DOI:
https://doi.org/10.18203/2320-6012.ijrms20241563Keywords:
Acute intestinal obstruction, Gall bladder cancer, Gall bladder gangrene, Cholecystitis, Gall bladder perforationAbstract
Gangrenous cholecystitis is an uncommon cause of acute abdomen in surgery emergency. Most of the times, diagnosis is settled intraoperatively as signs and symptoms are non-specific. CT scan of abdomen can help in making a diagnosis but should be done only if the patient is stable. Here we have reported three cases in which laparotomy was done in view of acute abdomen with signs of peritonitis and gangrenous cholecystitis was found as an incidental finding. One patient had spontaneous gangrenous cholecystitis with gall bladder perforation with biliary peritonitis. The second patient had gangrenous gall bladder perforation secondary to gall bladder malignancy and the third patient had spontaneous gangrenous cholecystitis with terminal ileal stricture presenting as acute intestinal obstruction. A decision to perform cholecystectomy in such cases depends on the feasibility, general condition of the patient and the cause of gall bladder perforation.
Metrics
References
Fagan SP, Awad SS, Rahwan K, Hira K, Aoiki N, Itani KMF, et al. Prognostic factors for the development of gangrenous cholecystitis. Am J Surg. 2003;186(5):481-5.
Mehrzad M, Jehle CC, Roussel LO, Mehrzad R. Gangrenous cholecystitis: A silent but potential fatal disease in patients with diabetic neuropathy. A case report. World J Clin Cases. 2018;6(15):1007-11.
Rustagi T, Rai M, Menon M. Ruptured adenosquamous cell carcinoma of the gallbladder: case report and review of literature. Gastrointest Cancer Res. 2011;4(1):29-32.
Amarnath S, Polavarapu A, Gumaste V. Spontaneous Perforation of an Acalculous Hydropic Gallbladder in a Diabetic Patient With Neuropathy: An Underdiagnosed Entity. Gastroenterol Res 2019;12(6):315-9.
Hosaka A, Nagayoshi M, Sugizaki K, Masaki Y. Gallbladder perforation associated with carcinoma of the duodenal papilla: a case report. World J Surg Oncol. 2010;8:41.
Sun Y, Song W, Hou Q, Gua H. Gallbladder perforation: a rare complication of postoperative chemotherapy of gastric cancer. World J Surg Onc. 2015;13:245.
Stefanidis D, Sirinek KR, Bingener J. Gallbladder perforation: risk factors and outcome. J Surg Res. 2006;131(2):204-8.
Watanabe Y, Nagayama M, Okumura A, Amoh Y, Katsube T, Suga T, et al. MR imaging of acute biliary disorders. Radiographics. 2007;27(2):477-95.
Ausania F, Guzman Suarez S, Alvarez Garcia H, Senra del Rio P, Casal Nuñez E. Gallbladder perforation: morbidity, mortality and preoperative risk prediction. Surg Endosc. 2015;29(4):955-60.
Zhang J, Shen G, Shi Y, Zhang C, Hong D, Jin L, et al. Spontaneous acalculous gallbladder perforation in a man secondary to chemotherapy and radiation: A rare case report. Medicine (Baltimore). 2018;97(19):e0674.
Morosin T, De Robles M B, Putnis S. Gallstone Ileus: An Unusual Cause of Intestinal Obstruction. Cureus. 2020;12(3):e7284.
Sahsamanis G, Maltezos K, Dimas P, Tassos A, Mouchasiris C. Bowel obstruction and perforation due to a large gallstone. A case report. Int J Surg Case Rep. 2016;26:193-6.
Ramesh D, Apoorva G. Gangrenous Cholecystitis Masquerading as Intestinal Obstruction, A Silent Killer. Int J Sci Res. 2023;12(4):860-63.
Croley GG 2nd. Gangrenous cholecystitis: five patients with intestinal obstruction. Am Surg.1992;58(5):284-92.