One of the urgent conditions requiring surgical intervention is a rupture (perforation) of the walls of the gallbladder. As a rule, this pathology develops as a result of chronic diseases of the liver and biliary tract, in some cases, the cause may be an injury to the abdomen. It is worth mentioning that the symptoms of gallbladder rupture in dogs and cats are similar to those in humans.
Reasons
Rupture (perforation) of the walls of the gallbladder is preceded by certain causes. Prerequisites for the development of such a pathological condition may be certain conditions.
- Inflammatory focal processes occurring directly in the gallbladder itself, resulting in the destruction of the walls of the organ, which in turn leads to the formation of ruptures on them. As a rule, ruptures of the gallbladder are the result of cholecystitis (a chronic disease of the bile ducts).ways). 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 (press) or lead to necrosis of the walls of the organ itself.
- Various injuries, blows, cuts in the right hypochondrium can provoke mechanical perforation and rupture of the walls of the gallbladder.
Symptoms of the disease
For positive prognosis and effectiveness of treatment, timely diagnosis is necessary, which is based on the prompt preparation of an anamnesis. At the same time, the analysis and comparison of symptoms characteristic of gallbladder perforation play an important role. For each form, the symptoms of gallbladder rupture are separate. It is worth looking into them in more detail.
Sharp shape
The acute form of the development of pathology is characterized by signs similar to acute cholecystitis, which is often the cause of perforation, including:
- general signs of inflammation: body temperature rises sharply, the patient refuses to eat, complains of nausea and frequent vomiting;
- skin and partially mucous membranes become yellow;
- recorded acute pain in the right hypochondrium, palpation intensifies the pain, the condition and reaction of the skin and muscles at the site of pain are similar to typical peritonitis.
Subacute form
Symptomaticssubacute gallbladder rupture (in which a subhepatic abscess forms) has certain typical features, including:
- general fever (from chills to a feeling of heat 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 condition may develop in the body as a result of the spread of putrefactive bacteria and microorganisms.
Chronic form
If small ruptures of the gallbladder are not diagnosed in time and adequate treatment is not carried out, the disease can become chronic, characterized by the formation of fistulas in the biliary tract. This condition has the following symptoms:
- intestinal obstruction due to small gallstones;
- through the formed fistulas, various bacteria from the intestines, 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).
There are such symptoms of gallbladder rupture in cats and dogs.
Diagnosis
It should be noted that such a development of the disease can be diagnosed only with the help of instrumental studies during laparoscopy. When forming an anamnesis onregarding the rupture of the gallbladder, it is necessary to pay attention to the presence of chronic diseases of the liver and biliary tract in a person, while assessing the patient's previous complaints about digestive disorders (constipation, diarrhea, excessive gas formation), reactions to fatty and fried foods, spread of pain sensations.
Tests
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 the dynamics of ESR growth. 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 vesico-intestinal fistulas.
Treatment
Speaking about the methods of treatment of rupture of the walls of the gallbladder, it should be noted that self-treatment in the event of the development of this pathology is unacceptable and can lead to serious consequences, such asperitonitis and sepsis, which can lead to death. First of all, it is necessary to treat the symptoms of gallbladder rupture and then proceed to the direct elimination of the pathology.
All therapeutic and other activities related to the treatment of gallbladder rupture should be carried out in a medical hospital under the supervision of the attending physician. With obvious signs indicating physical damage to the walls and tissues of the gallbladder, a decision should be made within one hour to hospitalize the patient and surgically eliminate the pathology.
- If wall ruptures are confirmed, then in this case, surgical correction (suturing of the walls) of the organ is performed.
- In case of developed peritonitis, the abdominal cavity is freed from the resulting fluid and treated with antiseptic solutions.
- If gallstones are found during surgery in the gallbladder cavity, then a decision is made on cholecystectomy (removal of stones from the gallbladder). This is necessary to prevent further development of the disease and its recurrence.
- If ruptures of the walls of the gallbladder are not the result of the presence of stones in the cavity of the organ, then during surgical intervention it is necessary to establish the presence or absence of fistulas in the biliary tract.
- The reason for the development of an urgent condition may be an increase in the size of the pancreas, which prevents the free flow of bile from the organ cavity.
- After surgery, in the postoperative periodthe patient is prescribed a course of appropriate antibiotics to prevent the development of inflammatory foci at the site of sutures (both internal and external).
Here it would be appropriate to say that timely hospitalization of a patient with acute cholecystitis and appropriate drug therapy can prevent rupture 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;
- if small stones are found in the cavity of the gallbladder, the use of therapy to remove them is recommended (from dissolving with special medical agents to crushing these stones using the latest modern methods, such as laser crushing).
Consequences
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 a rupture of the gallbladder can be considered the development of bile peritonitis, subhepatic abscess or prolapse of a stone in the intestinal region, which is fraught with intestinal obstruction. All of these conditions require immediate medical attention.
