Published online Oct 27, 2024. doi: 10.4240/wjgs.v16.i10.3301
Revised: August 23, 2024
Accepted: September 3, 2024
Published online: October 27, 2024
Processing time: 178 Days and 3 Hours
Gallbladder perforation is a serious complication of acute cholecystitis. Such perforation is a rare but life-threatening situation that can lead to the formation and rupture of liver hematomas. Here, we report a case of a ruptured intrahepatic hematoma caused by intrahepatic gallbladder perforation, and we present a literature review.
A 70-year-old male was admitted to the hospital with a complaint of right upper quadrant abdominal pain, flustering and dizziness. The preoperative diagnosis was a ruptured malignant liver tumor, and the patient’s medical images and increased level of carbohydrate antigen-199 suggested that the gallbladder had been invaded. However, the tumor was proven to be a liver hematoma secondary to gallbladder perforation after surgery. The patient was discharged uneventfully on the fifteenth postoperative day.
Intrahepatic gallbladder perforation is difficult to diagnose preoperatively. Radiological examinations play a crucial role in the diagnosis but only for partial cases. Early diagnosis and appropriate surgery are key to managing this rare condition.
Core Tip: In this work, we present a rare clinical case in which a ruptured malignant liver tumor with invasion of the gallbladder was suspected but was proven to be a liver hematoma secondary to gallbladder perforation after surgery. Moreover, we conducted a literature review on intrahepatic gallbladder perforation. Here, the symptoms, examinations, diagnosis and treatments of intrahepatic gallbladder perforation are summarized. Additionally, we propose a new classification system for gallbladder perforation, which provides a valuable reference for the diagnosis and treatment of this condition.