Spontaneous Idiopathic Perforation Of Gall Bladder In Neonates

ABSTRACT

This is a case series of 3 neonates with features of acute abdomen. The first neonate presented on day 6 of life with convulsions and fever. He developed abdominal distension and had bilious vomiting by day 11 of life. After clinical and radiological diagnosis of intestinal obstruction and failure to resolve with conservative management, laparotomy was done which revealed multiple inter bowel loop adhesions and an omental band adherent to distal ileum. On exploration, a localised abscess was seen around the gall bladder , a 0.5cm diameter perforation in the gall bladder. Exploratory laparotomy with cholecystectomy was done. The other two neonates presented with similar features and exploratory laparotomy with cholecystectomy was done. Perforation of the gall bladder is a rare cause of neonatal intestinal obstruction. The management is surgical and cholecystectomy or sewing the perforation should depend on the size of the perforation and the extent of peritonitis