Abstract
Introduction : In the vast majority of cases in which free intraperitoneal air is seen, the causative disease is perforation of the gastrointestinal tract. We present two cases of free intraperitoneal air caused by perforation of the gallbladder.
Case 1 : A 94-year-old man who was brought into our hospital by ambulance showed to have free intraperitoneal air on an abdominal CT scan. On the same day, emergency operation was performed with a diagnosis of gastrointestinal perforation. At surgery perforation site was found not to exist in the gastrointestinal tract but in the gallbladder. Case 2 : A 78-year-old man who was hospitalized in other hospital because of appetite loss and dyspnea showed to have free intraperitoneal air by an abdominal CT scan. He was then brought into our hospital by ambulance with a diagnosis of gastrointestinal perforation. Emergency operation performed on the same day disclosed perforation site not to exist in the gastrointestinal tract but in the gallbladder. Consideration : We have experienced two cases of gallbladder perforation with free intraperitoneal air. So far other two similar cases have been reported in the Japanese literature. This disease that has been reported in only a total of four cases including our two cases is a relatively rare entity. Conclution : These cases emphasize the importance of considering gallbladder perforation in the differential diagnosis other than gastrointestinal perforation when free intraperitoneal air is identified.
