Gall Bladder Perforation Secondary to Enteric Fever: An Interesting Case of Acute Abdomen

ABSTRACT

Gallbladder perforation usually occur in acute obstructive (calculus) cholecystitis, and its incidence is high in patients with diabetes mellitus, recent severe trauma, critical illness, severe burn. 2-11% patients of acute cholecystitis progress to gallbladder perforation. Acute cholecystitis is a rare complication of enteric fever and perforation of gallbladder in such cases is an uncommon occurrence in pediatric population. Clinical features of spontaneous gall bladder perforation are non-specific especially in children. Ultrasound as well as computerized tomography (CT) abdomen and pelvis lack specificity for detecting gallbladder perforations in enteric fever. Diagnosis is usually confirmed intraoperatively when the gallbladder is visualized and perforation is seen. Hence the treating surgeon must consider this rare condition in differential diagnosis while treating any child with acute abdomen.