Hemoperitoneum and sepsis from transhepatic gallbladder perforation of acute cholecystitis: A case report

Fumio Chikamori, MD; Sawaka Yukishige; Koji Ueta, MD; Haruka Takasugi; Kai Mizobuchi; Hisashi Matsuoka, MD; Norihiro Hokimoto, MD; Hiromichi Yamai, MD; Kazuhisa Onishi, MD; Nobuyuki Tanida, MD; Nobumasa Hamaguchi, MD; Takehiro Iwasaki

Radiology Case Reports (Nov 2020)

Hemoperitoneum and sepsis from transhepatic gallbladder perforation of acute cholecystitis: A case report

Fumio Chikamori, MD,
Sawaka Yukishige,
Koji Ueta, MD,
Haruka Takasugi,
Kai Mizobuchi,
Hisashi Matsuoka, MD,
Norihiro Hokimoto, MD,
Hiromichi Yamai, MD,
Kazuhisa Onishi, MD,
Nobuyuki Tanida, MD,
Nobumasa Hamaguchi, MD,
Takehiro Iwasaki

Affiliations

Fumio Chikamori, MD: Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan; Corresponding author.
Sawaka Yukishige: Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan
Koji Ueta, MD: Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan
Haruka Takasugi: Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan
Kai Mizobuchi: Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan
Hisashi Matsuoka, MD: Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan
Norihiro Hokimoto, MD: Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan
Hiromichi Yamai, MD: Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan
Kazuhisa Onishi, MD: Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan
Nobuyuki Tanida, MD: Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan
Nobumasa Hamaguchi, MD: Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan
Takehiro Iwasaki: Department of Gastroenterology, Japanese Red Cross Kochi Hospital, Kochi, Japan

Journal volume & issue: Vol. 15, no. 11
pp. 2241 – 2245

Abstract

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We report a case of hemoperitoneum and sepsis from transhepatic gallbladder perforation in an 87-year-old male with acute cholecystitis who had past history of endoscopic sphincterotomy for common bile duct stone. Contrast-enhanced computed tomography (CT) showed intrahepatic and subcapsular low density areas. A wall defect of gallbladder was seen in coronal and sagittal - sections at the liver bed. Fluids obtained through the paracentesis were hemorrhagic. Percutaneous transhepatic gallbladder drainage (PTGBD) was attempted. First cholangiography revealed an orifice of fistula. Further injection of contrast medium drained into the intrahepatic secondary abscess and intraperitoneal cavity confirming the diagnosis of transhepatic gallbladder perforation. We conclude that contrast-enhanced CT with coronal and sagittal - sections and cholangiography via PTGBD tube are useful to confirm diagnosis of transhepatic gallbladder perforation.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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