Haemorrhagic hydrops of the gallbladder

Abstract

The gallbladder is afforded anatomical protection from external blunt injury, being cushioned by the surrounding omentum and intestines. Partially embedded in the liver substance and shielded by the bony cartilaginous rib cage, it is rarely injured. Although 70 per cent of injuries to the extrahepatic biliary tract involve the gallbladder, injury to this hollow viscus occurs in only 2-3 per cent of all blunt abdominal injury’,‘. The reason for this rarity is the ability of the surrounding structures to dissipate the kinetic energy that might otherwise damage the gallbladder. Indeed, the traumatized gallbladder is most often recognized incidentally during laparotomy performed for other intra-abdominal injuries. Isolated gallbladder trauma resulting from nonpenetrating injury is difficult to diagnose. The physical examination signs are not as evident as with other hollow organ injuries. This paper describes a case of isolated gallbladder injury in which acute cholecystitis developed as a result of blunt injury with spontaneous haemorrhage into the gallbladder lumen. Pathological examination did not reveal any wound of the gallbladder. The use of radiographic imaging techniques to facilitate early diagnosis is emphasized.