Abstract
We report a case of idiopathic perforation of the gallbladder (IPG). The patient was a 57-year-old woman who presented with acute-onset abdominal pain. Physical examination showed peritoneal signs. CT showed ascites ; therefore, she underwent emergency laparotomy. Intraoperative findings showed bile leakage from the gallbladder. Therefore, she underwent a cholecystectomy. Microscopic examinations showed a perforation in the body of the gallbladder. Cholecystitis or gallstones were not noted. Therefore, she was diagnosed with IPG. Microscopic examinations also showed vasculitis and thrombus in the adjacent gallbladder wall, which was likely closely linked to the perforation. Her ascites amylase level was 31,800 IU/L, presumably due to pancreatobiliary reflux in the absence of pancreatobiliary maljunction. IPG should be considered in the differential diagnosis of acute abdominal pain accompanying a high amylase level in ascites.
