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Case report- acute pre-operative gall bladder perforation (Type-1) with generalized biliary peritonitis in younger age group without any comorbid illness.

ABSTRACT: Gall bladder related disease is now one of the commonest indications for elective and emergency surgery and laparoscopic cholecystectomy is the mainstay treatment in patients with gall bladder stones, however some patient delay their surgical intervention for some period of time which might lead to life threatening complications in later stages such as GBP which is rarest but when it occurs along with other predisposing risk factors (hypoalbuminemia and SIRS) might increase the morbidity and mortality rate. Here we report a case of pre-operative Type-I GBP with generalized biliary peritonitis with sepsis with hypoalbuminemia in younger age group. Acute cholecystitis patient of younger age group without any comorbid illness, needs prompt surgical intervention (cholecystectomy).

SUBMITTER: Khetarpal A

PROVIDER: S-EPMC8050705 | biostudies-literature | 2021 Apr

REPOSITORIES: biostudies-literature

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Case report- acute pre-operative gall bladder perforation (Type-1) with generalized biliary peritonitis in younger age group without any comorbid illness.

Khetarpal Anil A Khetarpal Ayush A

Annals of medicine and surgery (2012) 20210327

Gall bladder related disease is now one of the commonest indications for elective and emergency surgery and laparoscopic cholecystectomy is the mainstay treatment in patients with gall bladder stones, however some patient delay their surgical intervention for some period of time which might lead to life threatening complications in later stages such as GBP which is rarest but when it occurs along with other predisposing risk factors (hypoalbuminemia and SIRS) might increase the morbidity and mor ...[more]

PMID: 33889403

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Project description:BackgroundGas extravasation complications arising from perforated diverticulitis are common but manifestations such as pneumoperitoneum, pneumoretroperitoneum, and pneumomediastinum happening at the same time are exceedingly rare. This case report explores the unique presentation of these 3 complications occurring simultaneously, their diagnosis and their management, emphasizing the importance of interdisciplinary collaboration for accurate diagnosis and effective management.Case presentationA 74-year-old North African female, with a medical history including hypertension, dyslipidemia, type 2 diabetes, goiter, prior cholecystectomy, and bilateral total knee replacement, presented with sudden-onset pelvic pain, chronic constipation, and rectal bleeding. Clinical examination revealed hemodynamic instability, hypoxemia, and diffuse tenderness. After appropriate fluid resuscitation with norepinephrine and saline serum, the patient was stable enough to undergo computed tomography scan. Emergency computed tomography scan confirmed perforated diverticulitis at the rectosigmoid junction, accompanied by the unprecedented presence of pneumoperitoneum, pneumoretroperitoneum, and pneumomediastinum. The patient underwent prompt surgical intervention with colo-rectal resection and a Hartmann colostomy. The postoperative course was favorable, leading to discharge one week after admission.ConclusionsThis case report highlights the clinical novelty of gas extravasation complications in perforated diverticulitis. The unique triad of pneumoperitoneum, pneumoretroperitoneum, and pneumomediastinum in a 74-year-old female underscores the diagnostic challenges and the importance of advanced imaging techniques. The successful collaboration between radiologists and surgeons facilitated a timely and accurate diagnosis, enabling a minimally invasive surgical approach. This case contributes to the understanding of atypical presentations of diverticulitis and emphasizes the significance of interdisciplinary teamwork in managing such rare manifestations.

Dataset Information

Case report- acute pre-operative gall bladder perforation (Type-1) with generalized biliary peritonitis in younger age group without any comorbid illness.

Publications

Case report- acute pre-operative gall bladder perforation (Type-1) with generalized biliary peritonitis in younger age group without any comorbid illness.

Similar Datasets

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