A Race Against Rupture: Saving a Diabetic From Gallbladder Perforation

Gallbladder empyema represents a serious complication of acute cholecystitis and can progress to perforation, particularly in elderly or immunocompromised individuals. If not managed promptly, gallbladder perforation may lead to generalized biliary peritonitis, sepsis, and increased mortality. We report the case of a 57-year-old woman with type 2 diabetes mellitus (T2DM) who developed gallbladder empyema that progressed to free fundal perforation with associated biliary peritonitis. She was successfully treated with emergency open subtotal cholecystectomy. This case highlights the critical importance of early diagnosis and coordinated multidisciplinary intervention to prevent life-threatening outcomes.