What is a gallbladder rupture?

The gallbladder is a small organ located near your liver. It stores bile, which is a liquid produced in the liver. The gallbladder releases bile into the small bowel to help break down fats.

A gallbladder rupture is a medical condition where the gallbladder wall leaks or bursts. Ruptures are commonly caused by inflammation of the gallbladder. This inflammation can be caused by gallstones, which can get stuck inside the gallbladder. Infection can also cause inflammation that could lead to rupture. In rare cases, an injury can cause a rupture.

If your gallbladder ruptures, you may have sudden, sharp severe abdominal pain. The pain might be short-lived after the rupture. But the pain often returns when the rupture site with leaking content grows or becomes inflamed or infected. An untreated ruptured gallbladder can cause systemic inflammatory response syndrome (SIRS) within the body. If there’s underlying infection with SIRS, also called sepsis, this type of infection can be life-threatening.

Causes of a gallbladder rupture

Ruptures are generally caused by inflammation of the gallbladder or a blunt injury.

Causes of gallbladder inflammation leading to rupture include:

gallstones, which are the most common cause of inflammation

ascariasis, which is caused by parasitic worms and can lead to biliary disease

bacterial infections, such as those caused by Escherichia coli, Klebsiella, or Streptococcus faecalis

biliary sludge, which is a mixture of bile and particle matter that can clog the gallbladder

Causes of blunt injury that can rupture the gallbladder include:

motor vehicle accidents

falls with impact to the abdomen

direct blows from contact sports, such as soccer, wrestling, or rugby

Symptoms of gallbladder rupture

Symptoms of a ruptured gallbladder shouldn’t be ignored. Seek immediate medical attention if you experience any gallbladder rupture symptoms. These symptoms may include:

nausea and vomiting

sharp pain in right upper quadrant of your abdomen

jaundice, which is a yellowing of the skin and eyes

fever

Diagnosing a gallbladder rupture

It might be difficult for your doctor to diagnose a ruptured gallbladder because your symptoms may resemble symptoms of gallbladder inflammation. If your doctor diagnoses you with gallbladder inflammation when it’s really to the point of gallbladder rupture, they may give you the wrong treatment.

Your doctor may use a variety of diagnostic tests to check for a gallbladder rupture, such as:

ultrasound of the abdomen

color flow Doppler ultrasound

CT scan

biliary scintigraphy (HIDA scan), which uses a radioactive material injected into the body that is tracked with a specialized camera

Additionally, your doctor may order a series of blood tests to check for signs of inflammation, which could be due to a severe infection, including:

white blood cell count

c-reactive protein level

erythrocyte sedimentation rate

Elevated levels in any of these tests, along with positive symptoms and signs or imaging studies showing gallbladder disease, could indicate gallbladder inflammation, which is a risk for gallbladder rupture.

Treatment for gallbladder rupture

Gallbladder removal

Your doctor will recommend the best course of treatment after diagnosing your condition. Typically, a diagnosis is followed with quick treatment. Ideally, your doctor will want to remove the gallbladder before it ruptures. There’s a higher chance of complications if your gallbladder is removed after it ruptures.

The gallbladder can be removed with laparoscopic surgery. This is a minimally invasive surgery in which small incisions and specialized tools are used to remove the gallbladder. This technique has a lower risk of complications and usually requires a shorter hospital stay. Partial cholecystectomy is an option if you have significant inflammation or very fragile tissue that makes complete gallbladder removal difficult.

Treatment after surgery

It’s likely that you’ll require treatment after surgery. This may include antibiotics to clear a bacterial infection and a hospital stay to monitor your condition. A temporary low-fat diet may also be necessary. You may experience short-term difficulties with fat digestion and absorption after your gallbladder is removed.

You may also receive instructions for caring for your surgical incision(s) at home, and your doctor may prescribe pain treatment medications. Your doctor may prescribe a continued course of antibiotic therapy as a precaution against infection. You may also be instructed to avoid certain activities for a while.

Complications

Gallbladder ruptures should be taken very seriously. Bile is not supposed to be released into the abdominal cavity. One of the most deadly complications of a ruptured gallbladder with associated infection is sepsis. In this case, your body may go into shock or your organs may shut down if you don’t get treatment quickly. Your risk for this type of complication is higher if you have a weaker immune system.

Outlook for a gallbladder rupture

The outlook is promising when the gallbladder is removed before it ruptures. Not all ruptures occur in the same part of the gallbladder. Certain rupture locations make removal more difficult, which increases the risk of developing an infection. Serious complications of a rupture can be fatal.

People who receive a correct diagnosis and fast treatment can make a full recovery.