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Chikamori F, Yukishige S, Ueta K, Takasugi H, Mizobuchi K, Matsuoka H, Hokimoto N, Yamai H, Onishi K, Tanida N, Hamaguchi N, Iwasaki T. Hemoperitoneum and sepsis from transhepatic gallbladder perforation of acute cholecystitis: A case report. Radiol Case Rep 2020; 15:2241-2245. [PMID: 32952763 PMCID: PMC7486689 DOI: 10.1016/j.radcr.2020.08.064] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 08/28/2020] [Accepted: 08/30/2020] [Indexed: 11/05/2022] Open
Abstract
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.
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Affiliation(s)
- Fumio Chikamori
- Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan
| | - Sawaka Yukishige
- Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan
| | - Koji Ueta
- 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
- Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan
| | - Norihiro Hokimoto
- Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan
| | - Hiromichi Yamai
- Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan
| | - Kazuhisa Onishi
- Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan
| | - Nobuyuki Tanida
- Department of Surgery, Japanese Red Cross Kochi Hospital, Kochi, Japan
| | | | - Takehiro Iwasaki
- Department of Gastroenterology, Japanese Red Cross Kochi Hospital, Kochi, Japan
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