Gallbladder perforation in a patient with alcoholic liver cirrhosis and asymptomatic gallstones: A case report

RATIONALE: Gallbladder perforation is a relatively uncommon complication of alcoholic liver cirrhosis and may happen with or without gallstones. PATIENT CONCERNS: Here we report a 52-year-old male patient who was diagnosed as gallbladder perforation with chronic liver cirrhosis and asymptomatic gallstones. The patient was admitted with acute and severe abdominal pain during weight-bearing physical labor. He had a history of alcoholic liver cirrhosis but no chronic abdominal pain or gallstones. The patient presented with localized peritoneal irritation, and abdominal puncture showed non-clotting blood. A preliminary clinical diagnosis was made as hepatocellular carcinoma rupture based on imaging findings. However, this diagnosis changed to gangrenous cholecystitis with gallbladder perforation by the laparotomy examination. DIAGNOSES: He was diagnosed with gangrenous cholecystitis with gallbladder perforation. INTERVENTIONS AND OUTCOMES: The patient performed well postoperatively. LESSONS: This case suggests that gallbladder perforation should be considered as a potential cause of acute abdominal pain even without evidence of gallstones. Early examination with a laparotomy examination can help achieve a timely diagnosis.