Gallbladder perforation in cholecystitis with liver abscess formation and septic thrombophlebitis of portal vein mimicking presentation of liver malignancy

Intrahepatic Type II Gall Bladder Perforation Secondary to Acute Acalculous Cholecystitis

Gall bladder perforation is a rare but serious complication of acute cholecystitis. Gall bladder perforations commonly occur in patients with comorbidities and in association with gall stones. We report a rare occurrence of intrahepatic type II perforation of the gall bladder in a previously healthy elderly male with acalculous cholecystitis. Lack of early positive findings related to clinical assessment, laboratory workup, and imaging resulted in a challenging diagnosis. High degree of clinical suspicion and close monitoring in such patients is necessary to detect early deterioration and improve outcomes.