{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T19:45:40Z","timestamp":1757706340944,"version":"3.41.2"},"reference-count":8,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2021,6,22]],"date-time":"2021-06-22T00:00:00Z","timestamp":1624320000000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Acute acalculous cholecystitis remains an elusive clinical diagnosis possibly due to complex clinical setting in which this entity develops, lack of large prospective controlled trials that evaluate various diagnostic modalities, thus dependence on a small database for clinical decision making. Concealed gallbladder perforation is rare. Herein, we report an 82-year-old female who presented with a right upper quadrant pain and features of local peritonitis. Abdominal ultrasound was suggestive of cholecystitis while computed tomography (CT) scan reported a perforated gallbladder with pericholecystic fluid collection. The patient underwent successful cholecystectomy; and intra-operatively, similar findings as those reported on imaging were seen. Unfortunately, she succumbed shortly post-operatively due to pulmonary embolism. Our report highlights the importance CT scan in patients with vague abdominal symptoms followed by sudden resolution. It also reminds the importance of considering the diagnosis of concealed gallbladder perforation as a differential in patients with peritonitis, as it may be missed by routine radiological investigations.<\/jats:p>","DOI":"10.1093\/jscr\/rjab245","type":"journal-article","created":{"date-parts":[[2021,5,18]],"date-time":"2021-05-18T19:10:19Z","timestamp":1621365019000},"source":"Crossref","is-referenced-by-count":4,"title":["Concealed gallbladder perforation: a rare case report"],"prefix":"10.1093","volume":"2021","author":[{"given":"Jamil","family":"Suleiman","sequence":"first","affiliation":[{"name":"Department of General Surgery, Kilimanjaro Christian Medical Centre, Moshi, Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex","family":"Mremi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania"},{"name":"Department of Pathology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Murad","family":"Tarmohamed","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Kilimanjaro Christian Medical Centre, Moshi, Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adnan","family":"Sadiq","sequence":"additional","affiliation":[{"name":"Department of Radiology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jay","family":"Lodhia","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Kilimanjaro Christian Medical Centre, Moshi, Tanzania"},{"name":"Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,6,22]]},"reference":[{"key":"2021070811455217600_ref1","article-title":"Perforated gangrenous gallbladder in an asymptomatic patient","volume":"12","author":"Faraji","year":"2020","journal-title":"Cureus"},{"key":"2021070811455217600_ref2","first-page":"1","article-title":"Advanced gallbladder inflammation is a risk factor for gallbladder perforation in patients with acute cholecystitis","volume":"13","author":"Jansen","year":"2018","journal-title":"World J Emer Surg"},{"key":"2021070811455217600_ref3","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1007\/s42399-019-00101-5","article-title":"Spontaneous type 1 gallbladder perforation in an elderly patient presenting with acute generalised peritonitis: a case report","volume":"1","author":"Chaudhary","year":"2019","journal-title":"SN Compr Clin Med"},{"key":"2021070811455217600_ref4","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1148\/radiology.172.3.2672094","article-title":"Pericholecystic abscess: classification of US findings to determine the proper therapy","volume":"172","author":"Takada","year":"1989","journal-title":"Radiology"},{"key":"2021070811455217600_ref5","first-page":"1","article-title":"Histopathological findings in a COVID-19 patient affected by ischemic gangrenous cholecystitis","volume":"15","author":"Bruni","year":"2020","journal-title":"World J Emer Surg"},{"key":"2021070811455217600_ref6","first-page":"393","article-title":"Perforations of the gallbladder and cholecystobiliary fistulae: a review of management and a new classification","volume":"79","author":"Anderson","year":"1987","journal-title":"J Natl Med Assoc"},{"key":"2021070811455217600_ref7","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1148\/rg.2018170076","article-title":"Multimodality imaging, including dual-energy CT, in the evaluation of gallbladder disease","volume":"38","author":"Ratanaprasatporn","year":"2018","journal-title":"Radiographics"},{"key":"2021070811455217600_ref8","doi-asserted-by":"crossref","first-page":"7146","DOI":"10.21608\/ejhm.2018.17604","article-title":"Accuracy of ultrasound in diagnosis of cholecystitis","volume":"73","author":"Alshargi","year":"2018","journal-title":"Egypt J Hosp Med"}],"container-title":["Journal of Surgical Case 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