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Cirujano general

versión impresa ISSN 1405-0099


SEVILLA SANTOYO, Mizael Orlando; BOLANOS BADILLO, Luis Enrique  y  FRIAS ALMARAZ, Julián Felipe. Hepatic abscess secondary to intrahepatic pyocholecyst perforation. Cir. gen [online]. 2023, vol.45, n.1, pp.43-46.  Epub 30-Sep-2023. ISSN 1405-0099.


spontaneous gallbladder perforation is a rare complication of gallbladder pathologies, it’s seen in approximately 2% with mortality risk reported between 12-42%. If a secondary hepatic abscess is associated is even a less frequent complication.

Material and methods:

55 year old woman, who visits the emergency room referring approximately a month with abdominal pain which irradiates to the inter-scapular region. Laboratory tests reported elevated leukocytes, alkaline phosphatase and gamma glutamyl transferase. The contrasted abdominal CT showed a gallbladder with impacted biliary calculus, as well as an intrahepatic rupture of the gallbladder associated to a hepatic abscess.


a laparoscopic cholecystectomy, abscess drainage and intraabdominal drain placement was carried out. We used four laparoscopic trocars. We found a Parkland 5 gallbladder and a hepatic abscess in segments IV and V. The surgical piece was extracted with an extracting bag and 19 Fr drains were placed to Winslow hiatus and the abscess cavity.


gallbladder perforation with a secondary formation of a hepatic abscess is a very rare complication. It represents a diagnostic challenge, though due to recent diagnostic tools, prompt diagnosis is a possibility.

Palabras llave : gallbladder empyema; bilioma; gallbladder perforation; hepatic abscess; laparoscopy.

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