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Medicine (Baltimore). 2018 May;97(18):e0414. doi: 10.1097/MD.0000000000010414.

Gallbladder perforation in a patient with alcoholic liver cirrhosis and asymptomatic gallstones: A case report.

Author information

1
Department of Hepatobiliary Surgery, the First Hospital of Jilin University, Chaoyang District, Changchun, Jilin.
2
Department of General Surgery, Beijing Tsinghua Changgung Hospital Medical Center, Tsinghua University.
3
Department of ICU, Capital Medical University Affiliated Chao-Yang Hospital, Beijing.
4
Department of General Surgery, Tianjin Union Medical Center, Tianjin, China.

Abstract

RATIONALE:

Gallbladder perforation is a relatively uncommon complication of alcoholic liver cirrhosis and may happen with or without gallstones.

PATIENT CONCERNS:

Here we report a 52-year-old male patient who was diagnosed as gallbladder perforation with chronic liver cirrhosis and asymptomatic gallstones. The patient was admitted with acute and severe abdominal pain during weight-bearing physical labor. He had a history of alcoholic liver cirrhosis but no chronic abdominal pain or gallstones. The patient presented with localized peritoneal irritation, and abdominal puncture showed non-clotting blood. A preliminary clinical diagnosis was made as hepatocellular carcinoma rupture based on imaging findings. However, this diagnosis changed to gangrenous cholecystitis with gallbladder perforation by the laparotomy examination.

DIAGNOSES:

He was diagnosed with gangrenous cholecystitis with gallbladder perforation.

INTERVENTIONS AND OUTCOMES:

The patient performed well postoperatively.

LESSONS:

This case suggests that gallbladder perforation should be considered as a potential cause of acute abdominal pain even without evidence of gallstones. Early examination with a laparotomy examination can help achieve a timely diagnosis.

PMID:
29718836
PMCID:
PMC6392732
DOI:
10.1097/MD.0000000000010414
[Indexed for MEDLINE]
Free PMC Article

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