One of the urgent conditions requiring surgical intervention is a rupture (perforation) of the walls of the gallbladder. As a rule, this pathology develops due to chronic diseases of the liver and biliary tract, in some cases, the cause may be a trauma to the abdomen. It is worth mentioning that the symptoms of gallbladder rupture in dogs and cats are similar to human ones.
Causes
Gap (perforation) of the walls of the gallbladder is preceded by certain causes. Certain conditions may become prerequisites for the development of such a pathological condition.
- Inflammatory focal processes that occur directly in the gallbladder itself, the consequence of which is the destruction of the walls of the organ, which in turn leads to the formation of tears on them. As a rule, gallbladder ruptures are the result of cholecystitis (a chronic disease of the biliary tract). With this disease, the outflow of bile is difficult, which leads to perforation of the tissues of the bladder.
- The formation in the gallbladder of many characteristic gallstones that injure (pressure) or lead to necrosis of the walls of the organ itself.
- Various injuries, strokes, cuts in the right hypochondrium can provoke mechanical perforation and rupture of the walls of the gallbladder.
Symptoms of the disease
For positive prognoses and the effectiveness of treatment, timely diagnosis is necessary, which is based on the operational preparation of an anamnesis. In this case, the analysis and comparison of symptoms characteristic of perforation of the gallbladder play an important role. For each form, the symptoms of rupture of the gallbladder are separate. It is worthwhile to understand them in more detail.
Acute form
An acute form of pathology development is characterized by signs similar to acute cholecystitis, which is often the cause of perforation, including:
- general signs of inflammation: the body temperature rises sharply, the patient refuses to eat, complains of nausea and frequent vomiting;
- the skin and partially mucous membranes acquire a yellow tint;
- acute pain in the right hypochondrium is fixed, pain increases during palpation, the condition and reaction of the skin and muscles at the site of pain localization are similar to typical peritonitis.
Subacute form
Symptoms of the subacute form of rupture of the gallbladder (in the case when a subhepatic abscess forms ) has certain typical features, including:
- general fever (from chills to feeling hot in the body), bloating and heaviness in the abdomen, nausea, hypotension and palpitations;
- pain is also localized in the right hypochondrium;
- due to the fact that the formation of an abscess is associated with its suppuration, a septic state may develop in the body as a result of the spread of putrefactive bacteria and microorganisms.
Chronic form
In the event that small gallbladder ruptures are not diagnosed in time and adequate treatment is not carried out, the disease can go into a chronic form, characterized by the formation of fistulas in the biliary tract. The following symptoms are inherent in this condition:
- intestinal obstruction due to the ingress of small gallstones;
- through the formed fistula, various bacteria from the intestine, as a rule, enter the biliary tract, which leads to inflammatory processes with characteristic symptoms (fever, fever, weakness, liver pain, yellowing of the skin and mucous membranes).
These symptoms of gallbladder rupture in cats and dogs.
Diagnostics
It should be noted that such a development of the disease can be diagnosed only with the help of instrumental studies during laparoscopy. In the formation of an anamnesis about rupture of the gallbladder, it is necessary to pay attention to the presence of chronic liver and biliary tract diseases in a person, while previous complaints of the patient about digestive disorders (constipation, diarrhea, excessive gas formation), reactions to fatty and fried foods, the spread of pain are assessed .
Analyzes
An analysis of the characteristic symptoms of gallbladder ruptures cannot be carried out without special diagnostic measures that are necessary to confirm or refute the diagnosis.
- Blood sampling to determine the total number of leukocytes and growth dynamics of ESR. These indicators help to identify signs of general intoxication of the body and the development of inflammatory processes in it.
- Ultrasound examination of the abdominal cavity is designed to determine the localization of the lesion (rupture) of the organ wall and the presence of fluid in the abdominal cavity itself.
- Such an instrumental research method as laparoscopy is intended for the final confirmation of the diagnosis of gallbladder ruptures. The procedure is often prescribed if the walls of the gallbladder are not directly damaged, and the symptoms are caused by the presence of vesicenteric fistula.
Treatment
Speaking about methods of treating rupture of the walls of the gallbladder, it should be noted that self-medication in the case of the development of this pathology is unacceptable and can lead to serious consequences, such as peritonitis and sepsis, which can lead to death. First of all, it is necessary to treat the symptoms of gall bladder rupture and then proceed to the direct elimination of pathology.
All therapeutic and other measures associated with the treatment of rupture of the gallbladder should be carried out in a hospital under the supervision of a physician. With obvious signs of physical damage to the walls and tissues of the gallbladder, within one hour, a decision should be made on hospitalization of the patient and surgical removal of the pathology.
- If wall breaks are confirmed, then in this case, surgical correction (suturing of the walls) of the organ is performed.
- In the case of peritonitis, the abdominal cavity is freed from the resulting fluid and treated with antiseptic solutions.
- If gallstones are found during surgery in the cavity of the gallbladder, a decision is made on cholecystectomy (removal of stones from the gallbladder). This is necessary to prevent the further development of the disease and its relapses.
- If ruptures of the walls of the gallbladder are not a consequence of the presence of stones in the cavity of the organ, then with surgical intervention, it is necessary to establish the presence or absence of fistulas in the biliary tract.
- The cause of the development of the urgent state may be an increase in the size of the pancreas, which prevents the free outflow of bile from the organ cavity.
- After surgery, in the postoperative period, the patient is prescribed a course of appropriate antibiotics to prevent the development of inflammatory foci at the site of the sutures (both internal and external).
It will be appropriate here to say that timely hospitalization of a patient with acute cholecystitis and appropriate drug therapy can prevent ruptures of the walls of the gallbladder, namely:
- to relieve the inflammatory process, a course of antibiotics is prescribed with the simultaneous use of antispasmodics;
- pain is relieved by drugs of the analgesic group;
- in case of detection of small stones in the gallbladder cavity, it is recommended to use therapy to remove them (from dissolving with special medical devices to crushing these stones using the latest modern methods, for example, laser crushing).
Effects
Ruptures of the walls of the gallbladder in the absence of adequate treatment can lead to rather adverse consequences. The most dangerous symptom and consequence of rupture of the gallbladder can be considered the development of bile peritonitis, subhepatic abscess or prolapse of the stone in the intestine, which is fraught with intestinal obstruction. All of these conditions require immediate medical attention.