Perforation of gallbladder after admission in a young male patient

Gallbladder perforation is a rare but life threatening condition, and difficult to diagnose. A 30-year old male patient, with no known co-morbid, presented in emergency room with sudden onset of pain in the right hypochondrium. On examination there was tenderness in the right hypochondrium and right lumbar regions. Ultrasound abdomen showed thickwalled gallbladder containing multiple calculi and pericholecystic fluid suggestive of acute calculous cholecystitis. Patient was put on conservative treatment. After 24 hours patient deteriorated clinically. Urgent ultrasound showed collection in Morrison's pouch. Patient was operated and perforation at fundus of gallbladder found. Cholecystectomy was performed. Patient recovered smoothly and discharged home in good condition