Gali B M, Ali N, Agbese G O, Duna V D, Dawha S D, Ismai G I, Mohammed M
Department of Surgery, University of Maiduguri Teaching Hospital, Borno State, Nigeria.
Niger J Med. 2011 Jan-Mar;20(1):181-3.
Gallbladder perforation (GBP) is rare and as a complication of typhoid fever is extremely rare. We present two consecutive patients with GBP diagnosed incidentally at laparotomy.
Information on the management of two patients with gallbladder perforation seen at Federal Medical Centre Azare in June and October 2008 was extracted from their case records.
The two patients were both males aged 13 years and 16 years. They both presented with high fever of more than 2 weeks duration; and abdominal pain and distension. Both patients had features of generalised peritonitis. Pre-operative diagnoses of typhoid enteric perforation were made based on a positive Widal test. Intra-operative findings however, were that of bile peritonitis and gallbladder perforation. Both had cholecystectomy. Culture of the bile aspirate yielded Salmonella typhi.
Gallbladder perforation secondary to typhoid fever should be considered as a differential diagnosis in patients with suspected typhoid enteric perforation in typhoid fever endemic region.
胆囊穿孔（GBP）较为罕见，而作为伤寒热的并发症则极为罕见。我们报告两例在剖腹手术中偶然诊断出GBP的连续病例。
从2008年6月和10月在阿扎雷联邦医疗中心就诊的两名胆囊穿孔患者的病例记录中提取有关治疗的信息。
两名患者均为男性，年龄分别为13岁和16岁。他们均出现持续超过2周的高热，以及腹痛和腹胀。两名患者均有弥漫性腹膜炎的特征。术前根据肥达试验阳性诊断为伤寒肠穿孔。然而，术中发现为胆汁性腹膜炎和胆囊穿孔。两人均接受了胆囊切除术。胆汁抽吸物培养出伤寒沙门氏菌。
在伤寒热流行地区，对于疑似伤寒肠穿孔的患者，应将伤寒热继发的胆囊穿孔视为鉴别诊断之一。
