Spontaneous Intrahepatic Type II Gallbladder Perforation: A Rare Cause of Liver Abscess - Case Report

Abstract

A liver abscess formation is a rare complication of a gallbladder perforation, with a cholecystohepatic communication. Niemeier, in 1934, classified free gallbladder perforations and generalised biliary peritonitis as an acute or a Type I gallbladder perforation, a pericholecystic abscess and localised peritonitis as a subacute or a Type II gallbladder perforation, and cholecystoenteric fistulas as chronic or Type III gallbladder perforations. We are describing a 50-year-old male patient who presented with right upper quadrant pain and was found to have an intrahepatic perforation of the gallbladder. Our patient had a Type II perforation. We have discussed the diagnostic work-up and the management of this rare entity. Due to the high mortality that can be caused by a delay in making the correct diagnosis, a gallbladder perforation represents a special diagnostic and surgical challenge.

Keywords: Gallbladder perforation; Liver abscess; Niemeier classification.

[Table/Fig-1]:

An axial image of CECT abdomen reveals hepatic abscess communicate with gallbladder

[Table/Fig-2]:

CECT abdomen shows intrahepatic communication of gallbladder and hepatic abscess

[Table/Fig-3]:

Intraoperative findings gallbladder communicate with liver abscess cavity