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Chirurgia 2012 August;25(4):297-300

language: English

CT scan plays a fundamental role in diagnosis of alithiasic gallbladder perforation: case report with atypical clinical symptoms and discussion of the literature

Pierro A. 1, Berardi S. 2, Maselli G. 1, Spera G. 3, Princi P. 2, Sallustio G. 1

1 Radiology Department, “Giovanni Paolo II” Center for High Technology Research and Education in Biomedical Sciences, Sacro Cuore Catholic University, Campobasso, Italy;
2 Surgery Department, “Giovanni Paolo II” Center for High Technology Research and Education in Biomedical Sciences, Catholic Sacro Cuore Catholic University, Campobasso, Italy;
3 Division of Surgical Endoscopy, Surgery Department “Giovanni Paolo II”, Center for High Technology Research and Education in Biomedical Sciences, Sacro Cuore Catholic University, Campobasso, Italy


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We reported the case of an 47-year-old man who presented with an acute abdominal pelvic pain, fever and leucocytosis. This patient was known to our center because of a history of chronic pancreatitis without associated gallstones or indications to perform an endoscopic retrograde cholangiopancreatography (ERCP). The patient underwent abdominal ultrasound evaluation but only the computed tomography (CT) showed a gallbladder perforation with endo-abdominal fluid spillage. An explorative laparotomy has been carried out and revealed a gallbladder wall perforation in alithiasic colecystitis. This case emphasizes the fundamental role of computed tomography in the diagnosis of perforation of the alithiasic gallbladder, a rare etiology of acute peritonitis. Furthermore, this case describes an atypical symptoms for the perforation of the gallbladder, in fact the patient at admission only describes a sharp pain in lower abdomen, preceded by a sensation of descent of a fluid from the right upper quadrant of the abdomen up to the pelvic region .

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