SUSPECTED LARGE GALL BLADDER (GB) MUCOCELE EXTENDING FROM RIGHT HYPOCHONDRIUM UPTO RIGHT ILIAC REGION TURNED OUT TO BE GB PERFORATION IN A SCHIZOPHRENIC PATIENT: A RARE CASE REPORT AND LITERATURE REVIEW drprashantupadhyay16@gmail.com

 

SUSPECTED LARGE GALL BLADDER (GB) MUCOCELE EXTENDING FROM RIGHT HYPOCHONDRIUM UPTO RIGHT ILIAC REGION TURNED OUT TO BE GB PERFORATION IN A SCHIZOPHRENIC PATIENT: A RARE CASE REPORT AND LITERATURE REVIEW

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India

Poster Exhibition only

Gallbladder (GB) mucoceles, also referred to as GB hydrops, are rare pathological entities characterized by distention of the gallbladder due to the accumulation of viscid mucus, typically resulting from prolonged cystic duct obstruction—most commonly by an impacted gallstone. Within this uncommon spectrum, gallbladder perforation represents an exceptionally rare complication.

We report the case of a 70-year-old female who presented with a one-month history of nausea and vomiting following oral intake, without associated abdominal pain or fever. The patient had a five-year history of schizophrenia and no prior abdominal surgical history. Physical examination revealed a soft, non-tender, non-distended abdomen with a firm, palpable mass in the right hypochondrium extending to the right iliac fossa. There was no history of diabetes mellitus, tuberculosis, or asthma; however, the patient had been treated for lower limb filariasis four decades earlier. Ultrasound and contrast-enhanced computed tomography (CECT) of the abdomen revealed a large, lobulated, multiloculated cystic lesion measuring 20.7 × 5.9 cm, with an estimated volume of 120 mL, extending to the right iliac fossa

The patient was initially managed conservatively due to her asymptomatic status but later underwent emergency laparotomy following sudden clinical deterioration. Post-operatively, she was admitted to the ICU and succumbed on the third post-operative day.

This case underscores the diagnostic challenge posed by perforated GBs masquerading as mucoceles, particularly in asymptomatic patients. Diagnostic laparoscopy may serve as a crucial tool in guiding timely surgical intervention.