Isolated Gallbladder Injury Research Articles

Gallbladder injury in a catatrauma patient: a clinical case.

Gallbladder trauma is a rare medical emergency in abdominal surgery because of its anatomic location. Gallbladder injury occurs in only 1.9%-2.1% of cases with abdominal traumas, with an isolated injury being ten times rarer. Despite the different mechanisms of injury, intravesical hypertension is the most important factor contributing to gallbladder rupture. A fall from a height is a rare cause of gallbladder injury, with only a few cases described in the literature. Laparoscopic cholecystectomy is the most common primary treatment. In the present case report, we present the diagnosis and management of a patient with a rare combined trauma. The patient was polytraumatized but had an isolated gallbladder injury in the absence of other abdominal injuries. Modern diagnostic methods, primarily ultrasound, can be critical in determining the best treatment strategy.

Hemorrhagic cholecystitis from isolated gallbladder injury following blunt abdominal trauma: An unusual case report.

Introduction and importanceGallbladder contusion after blunt abdominal trauma is a rare event that presents with diagnostic challenges. There is no clear evidence supporting conservative or surgical management of gallbladder contusion injuries, especially when they present in isolation. Here, we report the first case of an isolated gallbladder contusion injury after blunt abdominal trauma resulting in hemorrhagic cholecystitis that was successfully managed non-operatively.Case presentationA 22-year-old male patient presented with a 3-day history of severe right upper quadrant pain, leukocytosis, and elevated bilirubin after suffering blunt abdominal trauma from being kicked in the abdomen during a soccer game. The patient was evaluated using computed tomography (CT), ultrasound (US), and magnetic resonance cholangiopancreatography (MRCP). His imaging findings were consistent with cholecystitis without cholelithiasis. His bloodwork and imaging were initially concerning for choledocholithiasis, but were later determined to be blood products within the common bile duct (CBD). Through conservative management, which included antibiotics, bed rest, and bowel rest, he had complete resolution of symptoms and normalization of bloodwork after four days of admission and remained symptom free at 1-year.Clinical discussionThis case serves to highlight isolated gallbladder contusion as a potential outcome of blunt abdominal trauma. We re-affirm the diagnostic inconsistencies between CT and US in the work-up of cholecystitis and other biliary pathology. Furthermore, we describe the role of non-operative management in the treatment of traumatic cholecystitis, in the absence of gallstones.ConclusionGallbladder contusion and hemorrhagic cholecystitis after blunt abdominal trauma can be managed with non-operative interventions.

Künt Travmaya Bağlı İzole Safra Kesesi Hematomunda Konservatif Tedavi

Isolated gallbladder injury after trauma occurs rarely and when unrecognized mortality is too high. In some hemodynamically suitable cases, conservative treatment may be the best choise for the patient. We presented a case with conservatively treated abdominal trauma after stucking in the elevator and had isolated gallbladder injury.

Closed Abdominal Trauma with Isolated Gallbladder Injury

Clinical observation of closed abdominal trauma and isolated gallbladder injury is discussed. The frequency of occurrence and risk factors for the development of gallbladder injury are presented.

Isolated gallbladder injury following blunt abdominal trauma: a case report

Isolated gallbladder injury following blunt abdominal trauma: a case report

2180 Why Is This Hemoperitoneum Orange? A Late Diagnosed Isolated Rupture of the Gallbladder Secondary to Blunt Abdominal Trauma

INTRODUCTION: The gallbladder is protected from blunt trauma by its unique anatomic position inferior to the liver and behind the rib cage. Biliary tree injuries are rare, occurring in approximately 2% of cases of blunt trauma. Isolated gallbladder injury is even rarer and the exact incidence is unknown. CASE DESCRIPTION/METHODS: 48 year old male with a history of alcohol abuse who was brought to the Emergency Department with right upper quadrant pain after falling over a fan. Labs showed stable chronic macrocytic anemia and elevated liver function tests. CT revealed ascitic fluid with suspected hemoperitoneum. Surgery managed the patient conservatively in light of stable serial hemoglobin values. Over the next 4 days, the patient developed shock with multi-organ failure. Primary team presumed deteriorating clinical status was related to alcoholic hepatitis and acute on chronic liver failure. Gastroenterology was then consulted and we recommended urgent diagnostic paracentesis. When smeared, the fluid was dark orange in color. A Medicine resident called the GI fellow and asked “why is this hemoperitoneum orange?” Ascitic bilirubin was 25 mg/dL. Surgery believed it was due to hemolysis of the hemoperitoneum. We transferred the patient for urgent ERCP that revealed external accumulation of contrast and bubbles in proximity to the gallbladder. A common bile duct stent was placed. Patient was taken for exploratory laparoscopy where a 5 cm defect on the anterior wall of gallbladder was noted and cholecystectomy was performed. Postoperative course was complicated by a 9 × 7 cm intra abdominal abscess. The collection was not amenable to Interventional Radiology drainage due to its proximity to the spleen. The patient underwent successful endoscopic cystogastrostomy with placement of a lumen apposing metal stent. DISCUSSION: Isolated gallbladder injury remains challenging to diagnose both clinically and radiologically. When suspected, percutaneous drainage is indicated to establish diagnosis even if radiological investigations are unrevealing. There is a high risk of morbidity and mortality secondary to a missed or delayed diagnosis. For patients in whom diagnosis is delayed, abdominal sepsis secondary to non-sterile biliary peritonitis can complicate the postoperative course. ERCP can be performed prior to surgery to reduce the pressure gradient between the biliary system and the duodenum allowing bile to drain preferentially into the duodenum.

Fatal Event of the Gallbladder Rupture Following the Blunt Abdominal Trauma: A Case Report

The gallbladder traumatic injury rarely happens due to its anatomical location and includes 2%-5% of trauma cases. The diagnoses of isolated gallbladder rupture in the blunt abdominal trauma are usually delayed and mostly revealed during the surgeries. To diagnose gallbladder injuries, the probability of injury in an organ such as gallbladder in the blunt abdominal trauma should be considered and accordingly the detailed diagnostic method should be used. A 85-year-old female was referred to the hospital due to facial and abdominal trauma. There was a mild tenderness in the right upper quadrant (RUQ) area. The hydrops gallbladder was observed in the focused assessment with sonography. The patient was assessed by abdominal ultrasonography after 48 hours and reports liver extensive rupture and sub-capsular hematoma. The patient was assessed by abdominal ultrasonography after 48 hours and reports liver extensive rupture and sub-capsular hematoma. The following day, the patient had severe bradycardia and finally dead due to asystole and cardiac arrest. In autopsy, the gallbladder rupture caused the green purulent bile discharge released over the abdomen. The current paper reports a case on isolated gallbladder injury following the blunt abdominal trauma which was not diagnosed in post-traumatic evaluations and was revealed by autopsy after patient’s death. The best method to diagnose gallbladder injuries is the computed tomography (CT) of the abdomen.

Ruptured Gall Bladder containing Stones following Blunt Trauma Abdomen: A Rare Presentation of Hemodynamic Instability

Gall bladder injuries are seen in 2% of patients undergoing laparotomy for blunt trauma abdomen. Isolated gall bladder injury is a rare event with associated presence of stones is even rarer. The associated visceral injuries lead to intraoperative identification in most cases. Here we present a case of 30 years old male with isolated gall bladder laceration following blunt abdominal trauma. The diagnosis of gallbladder perforation after blunt injury may be suspected in patients with signs of an acute abdomen and hypotension that is not explained by blood loss. Early suspicion and prompt exploration is imperative. Cholecystectomy is an adequate treatment for the condition.

Isolated gallbladder hematoma after a blunt abdominal trauma: case report

Background Sonography has played an important role on detection of intraabdominal injuries with a sensitivity of 86%, a specificity of 98%, and an accuracy of 97% [1]. Negative predictive value achieved about 98% [1]. However, gallbladder injury is rare with incidence around 2.1% [2,3] in blunt abdominal trauma [2], and commonly associated with the solid organ injury or abdominal vascular injury [4]. Isolated gallbladder injury were very few[3] including traumatic cholecystitis, gallbladder tear, and gallbladder perforation ...etc. Ultrasound is very sensitive to gallbladder disease. We presented a rare case of isolated gallbladder hematoma after a blunt abdominal trauma which diagnosis by Focused Gallbladder ultrasound.

Isolated gallbladder perforation following blunt abdominal trauma.

A 32-year-old man sustained an isolated perforation of the gallbladder following blunt abdominal trauma. A preoperative diagnosis was made on an ultrasound scan, which showed a pericholecystic fluid collection only. At laparotomy, a gallbladder perforation at the infundibulum was identified with a localised bile collection, warranting a cholecystectomy. Isolated gallbladder injury from blunt abdominal trauma is rare, and a high index of suspicion is required to establish the diagnosis. Cholecystectomy is the treatment of choice.

Isolated Gallbladder Injury in a Case of Blunt Abdominal Trauma

The diagnosis of blunt injury to the gallbladder may constitute a significant challenge to the diagnostician. There is often a delay in presentation with non-specific clinical symptoms. In the absence of reliable clinical symptoms, diagnostic imaging becomes an invaluable tool in the rapid identification of gallbladder injury. We present a case of isolated gallbladder injury following blunt abdominal trauma which was diagnosed by computed tomography and subsequently confirmed by cholecystectomy.

Isolated blunt traumatic gallbladder perforation demonstrated on MDCT and post-cholecystectomy bile leak revealed on Gd-EOB-DTPA (Primovist) enhanced MRCP

We report a rare case of isolated gallbladder injury following blunt abdominal trauma identified on MDCT prior to surgery. The patient had a bile leak post-operatively which was demonstrated on biliary phase Gd-EOB-DTPA (Primovist) enhanced MRI.

A Case of Successful Conservative Treatment of an Isolated Gallbladder Injury due to Abdominal Blunt Trauma

A Case of Successful Conservative Treatment of an Isolated Gallbladder Injury due to Abdominal Blunt Trauma

Colecistite aguda decorrente de hemorragia intraluminar da vesícula biliar após trauma abdominal fechado

Isolated gallbladder injury following abdominal blunt trauma is rare and early diagnosis is difficult to make, particularly when no other organ is injured. However, ultrasonography is valuable for investigating gallbladder injuries. We report a case of isolated gallbladder blunt trauma presented as acute cholecystitis with hemobilia. In isolated blunt traumatic injury to the gallbladder, treatment options vary depending on the specific injury. The characteristics of blunt trauma injuries to the gallbladder and their appropriate management are discussed.

Isolated Gallbladder Injury after Blunt Abdominal Trauma: a Case Report and Review.

We describe a case of isolated gallbladder contusion after deceleration trauma. On admission, no evident signs of intra-abdominal injury were present. However, after 24 h observation an explorative laparotomy was performed because of persistent abdominal complaints. A contusion of the gallbladder wall was found with intraluminal haematoma and a cholecystectomy was performed. Isolated injury of the gallbladder after blunt trauma is extremely rare. Risk factors are distention of the gallbladder, deceleration trauma and the presence of a relatively mobile gallbladder. Clinical signs often are very subtle. Delayed presentation is common with signs of hemobilia or obstruction due to intraluminal clots. Ultrasound and computed tomography are suitable diagnostic tools. However, the diagnosis is often missed if no other injuries are present. Signs pointing to gallbladder injury are a collapsed gallbladder with pericholecystic fluid or a hydroptic gallbladder with intraluminal hematoma. Hepatobiliary scintigraphy or angiography might be necessary if additional injuries are suspected. The choice of treatment depends on the kind of injury. Contusion of the gallbladder allows conservative treatment, but in case of a rupture, surgery will be necessary. Accompanying bile duct injuries can be treated by endoscopic stenting. If active arterial bleeding is present, selective embolization can be performed.

Isolated Gallbladder Injury after Blunt Abdominal Trauma: a Case Report and Review.

We describe a case of isolated gallbladder contusion after deceleration trauma. On admission, no evident signs of intra-abdominal injury were present. However, after 24 h observation an explorative laparotomy was performed because of persistent abdominal complaints. A contusion of the gallbladder wall was found with intraluminal haematoma and a cholecystectomy was performed. Isolated injury of the gallbladder after blunt trauma is extremely rare. Risk factors are distention of the gallbladder, deceleration trauma and the presence of a relatively mobile gallbladder. Clinical signs often are very subtle. Delayed presentation is common with signs of hemobilia or obstruction due to intraluminal clots. Ultrasound and computed tomography are suitable diagnostic tools. However, the diagnosis is often missed if no other injuries are present. Signs pointing to gallbladder injury are a collapsed gallbladder with pericholecystic fluid or a hydroptic gallbladder with intraluminal hematoma. Hepatobiliary scintigraphy or angiography might be necessary if additional injuries are suspected. The choice of treatment depends on the kind of injury. Contusion of the gallbladder allows conservative treatment, but in case of a rupture, surgery will be necessary. Accompanying bile duct injuries can be treated by endoscopic stenting. If active arterial bleeding is present, selective embolization can be performed.

Haemorrhagic hydrops of the gallbladder

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.

Gallbladder and extrahepatic biliary duct injury following abdominal trauma

Extrahepatic biliary tract and gallbladder injuries are rare, but many occur after both blunt and penetrating abdominal trauma. During a 5-year period, 24 patients requiring laparotomy for abdominal trauma were found to have an extrahepatic biliary tract injury, representing 13 per cent of all patients admitted with hepatic trauma during the same period. The majority of patients had injury to the gallbladder; only one case of common bile duct injury was identified. Of the patients, 50 per cent had an associated hepatic injury; 17 per cent had important pancreatic trauma. Isolated gallbladder injury occurred in only 8 per cent of patients. The overall mortality associated with gallbladder trauma was 16 per cent. This uncommon injury usually results from severe trauma and is associated with a high incidence of other major visceral injuries.