2008 Volume 28 Issue 6 Pages 851-853
An 82-year-old male was referred to our hospital because of severe abdominal pain and nausea. A contrast-enhanced computed tomography (CT) scan of the abdomen revealed free air areas not only in the abdominal cavity but also in the gallbladder. Based on these findings, we diagnosed the patient as having the diffuse peritonitis due to the gallbladder perforation, and he underwent an emergency operation. Intraoperative findings showed massive bilious fluid in the abdominal cavity and perforation of the gallbladder. Bile and black gallstones had leaked out through the gallbladder perforation. We performed a cholecystectomy, abdominal lavage and drainage. Preoperative diagnosis of gallbladder perforation is difficult, therefore it is often diagnosed intraoperatively. We report herein on a case of gallbladder perforation which could be diagnosed with a CT scan preoperatively.