GALLBLADDER PERFORATION, THOUGH A RARE PRESENTATION OF ACUTE ABDOMEN NEEDS IMMEDIATE INTERVENTION AND UTMOST EXPERTISE IN ITS MANAGEMENT

ABSTRACT- INTRODUCTION Gallbladder perforation is an unusual presentation that is rarely diagnosed preoperatively in a case of acute abdomen. It has a high mortality rate between 15- 45 percent because of delay in diagnosis. Timely intervention by an expert surgical team is the key in reducing morbidity and mortality.AIM To stress the importance of gallbladder perforation which should always be borne in mind as one of the differential diagnosis of acute abdomen because timely and optimal intervention saves the life of the patient.METHODS We present a series of 8 cases of gallbladder perforation which we encountered in our institution between August 2009 to August 2011. All cases presented with features of acute abdomen.These patients were diagnosed to have perforation based on their clinical presentation. All the patients were taken up for emergency laparotomy. Open cholecystectomy with peritoneal lavage and drainage was performed. Patients were given intensive post-op care, complications when encountered were managed accordingly.RESULTS All our patients presented with clinical features suggestive of perforative peritonitis The mean duration between admission and surgery was around 8 hrs. 6 had type I perforation and 2 had type II perforation with fundus being the most common site affected. One patient died of sepsis in the early post operative period.CONCLUSION-An aggressively oriented investigation strategm and surgical treatment of gallbladder perforation are of crucial importance in significantly reducing the morbidity and mortality of this condition which remained high throughout the literature.