Spontaneous perforation of gallbladder in a patient of end stage renal diseae on maintainance hemodialysis

Pages: 1104-1105
Vikram Kala (Department of Medicine, Bhagat Phool Singh Government Medical College for Women, Khanpur Kalan, Sonepat, Haryana)
Richa Kansal (Department of Obstetrics and Gynaecology Bhagat Phool Singh Government Medical College for Women, Khanpur Kalan, Sonepat, Haryana)
Prerna Panjeta (Department of Biochemistry, Bhagat Phool Singh Government Medical College for Women, Khanpur Kalan, Sonepat, Haryana)
Poonam Adlakha (Department of Histopathology, Venereology Postgraduate Institute of Medical Education and Research, Chandigarh)
Mohit Nagpal (Department of Dermatology and Venereology Postgraduate Institute of Medical Education and Research, Chandigarh)

Spontaneous gallbladder perforation in a patient of end stage renal disease is very umcommon event. It can lead to rapid deterioration of the patient with complicationg into sepsis and biliary peritonitis, often associated with high mortality. We report a case of 56 year old male patient of diabetic nephropathy and end stage renal disease who was on maintainance hemodialysis for past eight months. He reported to emergency room with acute abdomen and was subsequently diagnosed with gallbladder perforation. His current condition was complicated by his comorbid end stage renal failure. He recovered completely with early conservative antiobiotics therapy and aggressive hemodialysis. A prompt diagnosis and immediate initiation of antimicrobial therapy according to best guess antibiotic sensitivity are very important to optimize the management and prevent further deterioration of the patient.