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Title: Gallbladder Perforation as a Complication of Enteric Fever: An Intriguing Case of Acute Abdomen
Authors: Aleena Tahir, Mehwish Tabassum, Wajeeha Anum, Saba Khilji, Manal Niazi, Mashaal Shabrani
Journal: Journal of Islamabad Medical and Dental College (JIMDC)
Publisher: Healers Educational Society
Country: Pakistan
Year: 2024
Volume: 13
Issue: 2
Language: English
DOI: 10.35787/jimdc.v13i2.1086
Keywords: Salmonella typhiEnteric fevergall bladder perforationsubtotal cholecystectomy
If not identified and treated right once, gallbladder perforation—a uncommon but dangerousconsequence of acute cholecystitis—can result in significant morbidity and mortality. We describe theexample of a female patient, having 19 years of age, who had a history of constipation. The patient was diagnosed with typhoid fever and underwent imaging studies that revealed gallbladder wall perforation along its postero-inferior aspect with adjacent contained right subhepatic collection. The patient underwent diagnostic laparoscopy and subtotal cholecystectomy. This instance emphasizes how crucial it is to rule out gallbladder perforation while diagnosing acute abdomen in typhoid fever patients. Prompt surgical intervention and early diagnosis can avert major problems and enhance results.
To present a case of gallbladder perforation as a complication of enteric fever and emphasize the importance of early diagnosis and surgical intervention.
Case report detailing a 19-year-old female patient with a history of constipation, fever, and abdominal pain. Diagnostic workup included abdominal radiography, contrast-enhanced CT (CECT) abdomen and pelvis, and diagnostic laparoscopy. Treatment involved subtotal cholecystectomy, antibiotics, and supportive care.
graph TD;
A["Patient Presentation: Fever, Abdominal Pain"] --> B["Diagnostic Workup: Radiography, CECT"];
B --> C["Diagnosis: Typhoid Fever, Gallbladder Perforation"];
C --> D["Surgical Intervention: Laparoscopy, Subtotal Cholecystectomy"];
D --> E["Postoperative Care: Antibiotics, Supportive Care"];
E --> F["Outcome: Uneventful Recovery"];
The case highlights that gallbladder perforation, though uncommon, can be a serious complication of enteric fever, particularly in developing countries. The vague symptoms can make diagnosis challenging. Imaging modalities like CT and ultrasound are crucial for identification. Cholecystectomy is the preferred surgical treatment.
The patient was diagnosed with typhoid fever. Imaging revealed gallbladder wall perforation with an adjacent contained right subhepatic collection. Diagnostic laparoscopy confirmed multiple gallbladder perforations and a significant bilious collection. The patient underwent subtotal cholecystectomy and recovered uneventfully.
Gallbladder perforation as a complication of enteric fever requires prompt diagnosis and surgical intervention to prevent significant morbidity and mortality. This case underscores the importance of considering this complication in patients with acute abdomen and suspected enteric fever.
* The patient was a 19-year-old female. (Confirmed in text)
* The patient presented with a 10-day history of fever and abdomen pain. (Confirmed in text)
* The journal citation is J Islamabad Med Dental Coll. 2024; 13(2): 393-396. (Confirmed in text)
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