The gallbladder is a small, pear-shaped organ located beneath the liver in the upper right abdomen. Its primary function involves storing and concentrating bile, a greenish-brown fluid produced by the liver that aids in fat digestion. When fatty foods enter the digestive system, the gallbladder contracts and releases this concentrated bile into the small intestine through the common bile duct. A gallbladder rupture represents a severe medical emergency where the gallbladder wall tears, allowing bile to leak into the abdominal cavity.
Reasons for Rupture
The most frequent cause of a gallbladder rupture is acute cholecystitis, inflammation of the gallbladder. This inflammation commonly stems from gallstones, hardened deposits of bile that can obstruct the cystic duct. Blockages cause bile to build up, increasing pressure and distending the organ.
Bacterial infections can also contribute to inflammation and weaken the gallbladder wall, increasing the risk of rupture. If the inflammation progresses, the tissue of the gallbladder can die, a condition known as gangrene, which raises the likelihood of a tear. While less common, severe abdominal trauma can also cause the gallbladder to rupture. Tumors, though rare, may obstruct bile flow or directly invade the gallbladder wall, leading to a rupture.
Recognizing the Emergency
A ruptured gallbladder often presents with sudden, intense abdominal pain, localized in the upper right quadrant. The pain can be excruciating and may radiate to the back or right shoulder blade. Initial sharp pain might briefly subside after rupture, but often returns as inflammation or infection develops from leaking bile.
Nausea and vomiting may accompany the severe pain. Fever and chills also indicate an infection developing within the abdominal cavity. Jaundice, a yellowing of the skin and eyes, can occur if bile leakage affects liver function or causes a bile duct blockage. These symptoms signal peritonitis, an inflammation of the abdominal lining caused by bile and other substances spilling into the abdominal cavity, necessitating immediate medical attention.
Urgent Medical Intervention
Upon hospital arrival, medical professionals conduct a physical examination, often noting tenderness in the upper right abdomen. Blood tests check for infection signs, such as an elevated white blood cell count, and assess liver function through tests like bilirubin levels. Imaging studies then confirm the diagnosis and determine the rupture’s extent.
An abdominal ultrasound is often the initial imaging technique to visualize the gallbladder and detect fluid accumulation. For more detailed assessment, a CT scan or MRI may evaluate damage and guide treatment. Standard emergency treatment for a ruptured gallbladder involves immediate surgical removal of the organ, a cholecystectomy. During surgery, the abdominal cavity is thoroughly cleaned to remove leaked bile and prevent widespread infection. Intravenous antibiotics combat existing infections and prevent further complications, and fluid resuscitation helps stabilize the patient.
Path to Recovery
Following emergency cholecystectomy, patients typically spend a few days recovering in the hospital, though some may be discharged the same day if laparoscopic surgery was performed. Pain management is a priority, with prescribed medications to alleviate discomfort. Patients are encouraged to engage in light activity, such as walking, soon after surgery to aid recovery and prevent complications like blood clots.
Long-term recovery involves the body adapting to direct bile flow from the liver to the small intestine, bypassing the missing gallbladder. For the first few weeks, individuals may experience temporary digestive adjustments, including difficulty digesting fatty foods or diarrhea. Gradual dietary modifications, often starting with low-fat meals, help the digestive system adjust. While less common, potential complications during recovery can include wound infection or bile duct issues, which are closely monitored by the medical team.