A Case of Successful Surgical Treatment of Idiopathic Gallbladder Perforation with a Chronic Course

Abstract

An 81-year-old man was admitted to our hospital with a 7-day history of abdominal pain preceded by a 1-month history of diarrhea. Physical examination showed rebound tenderness in the whole abdomen. Computed tomography showed collapse of the gall bladder and massive peritoneal fluid accumulation in the abdominal cavity. There was no evidence of gall stones or free air in the abdomen. Abdominal paracentesis was performed and bile-like fluid was drained. Therefore, under a suspected diagnosis of gall bladder perforation, we performed emergency operation. The intraoperative findings showed biliary peritonitis and fur attached to the abdominal wall. The fundus of the gall bladder showed a perforation measuring 40 mm in diameter. Cholecystectomy and abdominal drainage were performed. The postoperative course was uneventful. Histopathological examination of the resected specimen revealed idiopathic rupture of the gall bladder. We encountered a case of idiopathic gall bladder perforation with a chronic course.