A Case of Idiopathic Perforation of the Gallbladder Associated with Arterio-venous Malformation

Satoshi Yoshikawa, Kazuhiro Iwase, Jun Higaki, Shoki Mikata, Minoru Miyazaki, Haruki Ide, Kentarou Nonaka, Masami Imakita* and Wataru Kamiike

Department of Surgery and Pathology*, Rinku General Medical Center, Izumisano Municipal Hospital

A 71-year-old man was admitted to our hospital because of abdominal pain. An emergency operation was performed following the diagnosis of acute peritonitis. After laparotomy, ascites containing bile was revealed in the peritoneal cavity. Necrosis of the wall was recognized at the body of the gallbladder. Cholecystectomy and bile duct drainage through the cystic duct using a C-tube were performed. No gallbladder stone or thickening of the gallbladder wall could be recognized. Postoperative cholangiography revealed neither a stone nor any anomaly of the biliary system. Histological examination revealed necrosis of the gallbladder, associated with thrombosis and an arterio-venous malformation in the body of the gallbladder. Other parts of the gallbladder wall presented less inflammatory changes. The arterio-venous malformation might be one of the causative factors for the idiopathic perforation of the gallbladder.

Key words
idiopathic perforation, gallbladder, arterio-venous malformation

Reprint requests
Satoshi Yoshikawa Department of Suegery, National Hospital Organization, Kinki-chuo Chest Medical Center
1180 Nagasone-cho, Sakai City, 591-8555 JAPAN

Accepted
February 25, 2004

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