Role of MSCT in the evaluation of perforated gall bladder (a retrospective study)

Gall bladder perforation (GBP) is a rare life threatening complication of acute cholecystitis, which has high morbidity and mortality. The aim of the study was to evaluate the role of multislice CT (MSCT) in the diagnosis of GBP and detection of its complications. Study included retrospective evaluation of 23 patients with GBP. All the patients were evaluated with abdominal ultrasonography and contrast-enhanced abdominal MSCT. Twenty-three patients were reviewed over a period of 18months: 7 patients with type I GBP, 16 patients with type II and no patients with type III GBP. Abdominal US showed gall stones, wall thickening, free intra-peritoneal fluid and pericholecystic fluid collection. GB wall defect could not be detected in US for all patients. Reviewing the MSCT, the most important point was the detection of wall defect, either single or multiple and its site: fundus (19 patients) or body (4 patients). 3 patients were associated with sub-hepatic abscess. MSCT was found to be a sensitive modality for the detection of GBP and its complication and we recommended MSCT for all cases suspected to have GBP.