Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Sep;7(9):2012-4.
doi: 10.7860/JCDR/2013/6069.3389. Epub 2013 Sep 10.

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

Kumkum Singh  1 , Amit Singh, Shivaji H Vidyarthi, Satyaprakash Jindal, Chandra Kumar Thounaojam
Affiliations

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

Kumkum Singh et al. J Clin Diagn Res. 2013 Sep.

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.

PubMed Disclaimer

Figures

[Table/Fig-1]:
[Table/Fig-1]:
An axial image of CECT abdomen reveals hepatic abscess communicate with gallbladder
[Table/Fig-2]:
[Table/Fig-2]:
CECT abdomen shows intrahepatic communication of gallbladder and hepatic abscess
[Table/Fig-3]:
[Table/Fig-3]:
Intraoperative findings gallbladder communicate with liver abscess cavity
See this image and copyright information in PMC

References

    1. Stefanidis D, Sirinek KR, Bingener J. Gall bladder perforation: Risk factors and outcome. J Surg Res. 2006;131:204–08. - PubMed
    1. Kochara K, Kevin V, George M, Vijay J. Intra–hepatic perforation of the gall bladder presenting as liver abscess: case report, review of literature and Niemeier’s classification. European Journal of Gastroenterology and Hepatology. 2008;20:240–44. - PubMed
    1. Singla SL, Garg P, Tahlan RN. Gall bladder carcinoma presenting as liver abscess. Indian J Gastroenterol. 1998 Apr;17(2):68. - PubMed
    1. Bhatwal Aaditya S, Deolekar S R, Karandikar Sangram S. An Unusual Presentation of Gall Bladder Perforation with Hepatic Subcapsular Collection. Indian journal of surgery. 2012 July DOI 10.1007/s12262-012-0581-x. - PMC - PubMed
    1. Naduthottam Palaniswami Kamalesh, Kaniyarakal Pramil, Kurumboor Prakash. Intrahepatic rupture of empyma gallbladder Indian. J Gastroenterol. September–October 2012;31(5):280. - PubMed

LinkOut - more resources