Abstract
A 74-year-old woman was admitted to our hospital with right upper quadrant pain after dinner. Blood tests revealed elevated pancreatic enzymes, however, an abdominal CT scan showed ascites in Morrison's pouch and no significant evidence for presence of pancreatitis or cholelithiasis. Although abdominal paracentesis showed no evidence of bile leak, we could not deny the possibility of biliary peritonitis. We performed endoscopic nasobiliary drainage (ENBD) and confirmed the improvement of her general condition. To investigate whether there is a perforation in the gallbladder, endoscopic nasogallbladder drainage (ENGBD) was performed. A leakage from the gallbladder was confirmed by ENGBD. Open cholecystectomy was performed with the preoperative diagnosis of idiopathic perforation of gallbladder. Histopathological examination showed a mild inflammation at the site of perforation without thrombosis. Here we report the first case of idiopathic perforation of gallbladder diagnosed by ENGBD.
