ABSTRACT
Gallbladder perforation is an infrequent but potentially fatal disease. It is extremely
rare during pregnancy. We report two cases of gallbladder rupture in the immediate
postpartum period and review the literature. The first patient was a 28-year-old polysubstance
abuser who presented at 29 weeks' gestation with generalized abdominal pain and ascites.
Over a 48-hour period, her abdominal pain increased, and preterm labor and delivery
occurred. She had an exploratory laparotomy the day after delivery for persistent
abdominal pain and ascites, and a ruptured, gangrenous gallbladder was found. This
patient died secondary to complications of the disease. Our second patient had a history
of cholelithiasis and developed abdominal pain on the third postpartum day. Three
days later, she was taken for exploratory laporatomy and was found to have a ruptured
gallbladder. She did well postoperatively. The signs and symptoms of a ruptured gallbladder
can be quite confusing in pregnancy. Ultrasonography, ascitic fluid analysis, computed
tomography, and magnetic resonance imaging are useful adjuncts in diagnosis. A high
index of suspicion, prompt recognition, and early surgical intervention are the mainstays
of therapy.
Keywords
Gallbladder perforation - pregnancy - abdominal pain
