How do you diagnose a perforated gallbladder?
Although standard abdominal CT has an important role in diagnosing gallbladder perforation, upper abdominal CT for acute cholecystitis in which pericholecystic fluid is found by US may increase the rate of preoperative diagnosis of gallbladder perforation..
How do you diagnose a perforated gallbladder?
Ultrasound, CT, or MRI may show a nonspecific complex fluid collection surrounding the gallbladder in patients with gallbladder perforation.
Focal disruption of the gallbladder wall may be seen on ultrasound, CT, and MRI (Figs. 1–3).
Inflammation surrounding the adjacent pericholecystic or omental fat may be seen..
What are the CT findings of the gallbladder?
The CT features of acute cholecystitis include gallstones, thickening of the gallbladder wall, pericholecystic fluid, stranding of the pericholecystic fat, high-attenuation bile, and blurring of the interface between the gallbladder and the liver [3] (Figs. 4,5,.
- A,
- B)
What is the common site of gallbladder perforation?
The fundus is the most frequent site of perforation because of the relatively poor blood supply in this area.
Associated complications include bacteremia, septic shock, bile peritonitis, and abscess formation, with mortality rates ranging from 6% to 70%..
What is the most common site of GB perforation?
GBP also develops following acalculous cholecystitis, although rare[10,11].
GB fundus, the most distal part with regard to blood supply, is the most common site of perforation[8,12].
The incidence of GBP was 4.5% and the most frequent site of perforation was the fundus (60%) in our study..
What is the most specific sonographic appearance for gallbladder perforation?
Sonographic findings for gallbladder perforation may include the presence of a stone outside of the gallbladder, an obvious defect in the gallbladder wall, and other signs such as distended gallbladder, thickened gallbladder wall, striated appearance of the gallbladder wall, gallstones, debris/sludge, and adjacent .
What is type 3 gallbladder perforation?
Gallbladder perforation is a complication of cholecystitis in 1 to 4 percent of cases.
Niemeier1 classified this complication in three types in 1934, and currently these are described as type 1—free perforation, type 2—perforation with abscess, and type 3—chronic perforation with cholecysto-enteric fistula..
Why do gallbladder perforate?
Gallbladder perforation can occur in the setting of cholelithiasis, cholecystitis, trauma, neoplasm, steroid use, or vascular compromise.
Perforation is most often a complication of severe acute cholecystitis, occurring in approximately 8% to 12% of cases..
- Biliary Scanning Technique.
The setup, transducer, and techniques are similar to liver scanning.
With the patient supine, place the transducer in a right subcostal, sagittal plane in the mid-axillary line and locate the gallbladder. - Gall bladder perforations are divided into three categories according to the chronicity (acute, subacute, and chronic) and type of perforation (into free abdominal cavity, development of a pericystic abscess, and development of fistulae).
- Gallbladder perforation is a complication of cholecystitis in 1 to 4 percent of cases.
Niemeier1 classified this complication in three types in 1934, and currently these are described as type 1—free perforation, type 2—perforation with abscess, and type 3—chronic perforation with cholecysto-enteric fistula. - The CT features of acute cholecystitis include gallstones, thickening of the gallbladder wall, pericholecystic fluid, stranding of the pericholecystic fat, high-attenuation bile, and blurring of the interface between the gallbladder and the liver [3] (Figs.
