Abstract
A 69-year-old man was admitted to the hospital because of abdominal pain and vomiting. There was tendemess and muscle guarding over the abdomen. Simple abdominal X-ray film revealed niveau formation of the small intestine. Ultrasonography and CT scan of the abdomen showed a fluid collection around the gallbladder. Under a diagnosis of generalized peritonitis, an emergency operation was performed. Laparotomy showed bilous fluid in the peritoneal cavity, and the bile leak was found from white-colored part of the gallbladder. Cholecystectomy and intraoperative cholangiogram were performed. Cholangiogram was negative for choledocholithiasis or long common channel. Culture of bile yielded no growth of bacteria. There were no evidence of thickness and no stone in the gallbladder. Histologically, ther was slight inflammatory change of the gallbladder wall and localized necrosis associated with venous thrombosis was found. The case reported here appears as spontaneous perforation of the gallbladder due to localized infarction.
