Hemoperitoneum and sepsis from transhepatic gallbladder perforation of acute cholecystitis: A case report

• Main Authors: Fumio Chikamori, MD, Sawaka Yukishige, Koji Ueta, MD, Haruka Takasugi, Kai Mizobuchi, Hisashi Matsuoka, MD, Norihiro Hokimoto, MD, Hiromichi Yamai, MD, Kazuhisa Onishi, MD, Nobuyuki Tanida, MD, Nobumasa Hamaguchi, MD, Takehiro Iwasaki
• Format: Article
• Language: English
• Published: Elsevier 2020-11-01
• Series: Radiology Case Reports
• Subjects: Transhepatic gallbladder perforation; Acute cholecystitis; Hemoperitoneum; Sepsis; Intrahepatic abscess; Percutaneous transhepatic gallbladder drainage
• Online Access: http://www.sciencedirect.com/science/article/pii/S1930043320304581
• ISSN: 1930-0433

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.