Rupture of the gallbladder is a medical condition in which the gallbladder begins to leak or bursts. The liver makes the body’s supply of bile. Bile helps break down fats during food digestion. Not all bile is needed at one time so excess is stored within the gallbladder.
Ruptures are most commonly caused by an inflammation of the gallbladder. The most common causes are gall stones, which get stuck inside the gallbladder. Rare cases are caused by an injury.
The initial symptom of a gallbladder rupture is generally a sudden onset of sharp or severe pain. Relief may shortly follow the rupture. The pain returns when the rupture site grows, becomes inflamed, or infected. Untreated, a ruptured gallbladder can result in an infection in the bloodstream (septicemia). Such an infection can be fatal.
Ruptures are generally caused by serious inflammation to the gall bladder. Rarer cases may be caused by a blunt injury.
Causes of gallbladder inflammation leading to rupture include:
- gall stones (most common cause for inflammation)
- ascariasis (parasitic worms, which cause biliary disease, or disease of the bile)
- bacterial infection (Escherichia coli, Klebsiella, Streptococcus faecalis etc)
- biliary sludge (mixture of bile and particle matter, which clogs the gall bladder)
Causes of blunt injury to the gall bladder:
- motor vehicle accidents
- falls in sports
- direct blows in sports (soccer, wrestling, rugby, etc.)
Symptoms of a ruptured gallbladder are to be taken seriously. If you are experiencing the symptoms of a gallbladder rupture, seek medical attention immediately.
Symptoms of gallbladder rupture may include:
- pain in upper right quadrant of body
- jaundice (yellowing of the skin caused by pressure and swelling around the gall bladder)
Diagnosis of gallbladder rupture is difficult. The symptoms resemble those of gallbladder inflammation, so doctors may administer the wrong treatment.
Diagnostic tests used to examine the presence of gallbladder rupture include:
- ultrasound of the abdomen
- color flow Doppler ultrasound
- biliary scintigraphy (best for diagnosis, uses radioactive materials injected into the body and then tracked with a specialized camera)
Your blood will be tested for signals of inflammation, which include:
- white blood cell count: high levels indicate infection
- c-reactive protein (CRP): elevated levels indicate inflammation
- erythrocyte sedimentation rate (ESR): high levels indicate inflammation
Diagnosis is followed by quick treatment. The best treatment is to remove the gallbladder before it ruptures. Removal after rupture has a higher chance of complications for the patient.
The gallbladder can be surgically removed laparoscopically, through an incision in the abdomen. This technique is associated with lower complication rates and a shorter hospital stay. Partial cholecystectomy is done in cases where inflammation or gallbladder position makes complete removal difficult.
Treatment after surgery may include:
- antibiotics to clear infections (infections may be caused by lingering inflammation)
- hospital stay (continued observation of the patient’s condition)
- temporarily low-fat diet (bile breaks down fats in the intestines; some patients may experience short-term difficulties in digestion after removal)
Gallbladder ruptures are to be taken very seriously. Bile is not supposed to be released into other areas of the body. The most deadly complication is when septicemia occurs (infection that has spread to the bloodstream). The body may go into shock or organs may begin shutting down if quick treatment is not administered. Those with previous infections are most at risk for this complication.
Outlook is best when the gallbladder is removed before it can rupture. Not all ruptures occur in the same position within the gallbladder. Certain positions make removal more difficult, which leads to an increase in developing infection. Serious complications of a rupture can be fatal.
Those who receive a correct diagnosis and fast treatment are capable of a full recovery. A course of antibiotics may be required as a precaution against infection.