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Liu DL, Pan JY, Huang TC, Li CZ, Feng WD, Wang GX. Isolated traumatic gallbladder injury: A case report. World J Gastrointest Surg 2023; 15:2639-2645. [PMID: 38111759 PMCID: PMC10725536 DOI: 10.4240/wjgs.v15.i11.2639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/20/2023] [Accepted: 09/27/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Isolated gallbladder injury (GI) (IGI) directly induced by abdominal trauma is rare. Symptoms, indications, and imaging examinations of IGI are frequently non-specific, posing tremendous diagnostic challenges, which are simple to overlook and may have severe implications. Improving doctors' understanding of gallbladder injury (GI) facilitates early detection and decreases the likelihood of severe consequences, including death. CASE SUMMARY We report a case of IGI caused by blunt violence (after falling from three meters with the umbilicus as the stress point) and performed laparoscopic repair of the gallbladder rupture, which helps clinicians understand IGI and reduce the severe consequences of delayed diagnosis. Through extensive medical history and dynamic abdominal ultrasound evaluation, doctors can identify GI early and begin surgery, thereby decreasing the devastating repercussions of delayed diagnosis. CONCLUSION This article aims to improve clinicians' understanding of IGI and propose a method for the diagnosis and treatment of GI.
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Affiliation(s)
- Dong-Liang Liu
- Department of Hepatobiliary & Pancreatic Surgery, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Jun-Yong Pan
- Department of Hepatobiliary & Pancreatic Surgery, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Tian-Cong Huang
- Department of Hepatobiliary & Pancreatic Surgery, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Cheng-Zong Li
- Department of Hepatobiliary & Pancreatic Surgery, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Wen-Du Feng
- Department of Hepatobiliary & Pancreatic Surgery, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
| | - Gao-Xiong Wang
- Department of Hepatobiliary & Pancreatic Surgery, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
- Department of Hospital Administration Office, Quanzhou Women's and Children's Hospital, Quanzhou 362000, Fujian Province, China
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Shah A, Cho T, Bokhari F. Isolated Traumatic Gallbladder Injury: A Rare Case. Cureus 2023; 15:e43982. [PMID: 37746348 PMCID: PMC10516145 DOI: 10.7759/cureus.43982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 09/26/2023] Open
Abstract
The prevalence of gallbladder injury in a traumatic event is rare, occurring in only 1.9%-2.0% of all abdominal traumas. Isolated gallbladder injuries, without any damage to surrounding organs or tissues, are even less common. Presenting symptoms are often nonspecific, and imaging modalities of ultrasound (US) and CT are usually relied upon to diagnose gallbladder injury accurately. Identifying and strategically treating cases of gallbladder injury, through reviewing this case report, are important for patient outcomes. We present a case of isolated gallbladder injury in a 27-year-old male after sustaining blunt-force abdominal trauma from a snowmobile injury. The patient presented to the emergency department (ED) three days after the initial injury with complaints of significant abdominal pain associated with eating solid food. Upon workup, he was found to have an isolated traumatic gallbladder injury for which a laparoscopic cholecystectomy was performed, and the patient was discharged with no complications. Gallbladder injury, with no evidence of other intra-abdominal injuries, is rare and often not considered in the differential for a trauma patient. Delayed intervention is associated with adverse patient outcomes, emphasizing the need to consider gallbladder injuries in patients presenting with abdominal pain, especially with a history of chronic alcohol use.
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Affiliation(s)
- Aashka Shah
- Surgery, Carle Illinois College of Medicine, Urbana, USA
| | - Timothy Cho
- General Surgery, Carle Foundation Hospital, Urbana, USA
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Jang H, Park CH, Park Y, Jeong E, Lee N, Kim J, Jo Y. Spontaneous resolution of gallbladder hematoma in blunt traumatic injury: A case report. World J Clin Cases 2021; 9:8518-8523. [PMID: 34754862 PMCID: PMC8554416 DOI: 10.12998/wjcc.v9.i28.8518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/12/2021] [Accepted: 08/05/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND We report a case of intragallbladder hematoma and biliary tract obstruction caused by blunt gallbladder injury. We report that the patient was safely treated by conservative treatment after the obstruction was resolved by endoscopic retrograde cholangiopancreatography (ERCP).
CASE SUMMARY A 67-year-old man was admitted via the emergency department due to complaints of right-sided abdominal pain that started 2 d prior. Four days prior to presentation, the patient had slipped, fallen and struck his abdomen on a motorcycle handle. His initial vital signs were stable. On physical examination, he showed right upper quadrant pain and Murphy’s sign, with decreased bowel sounds. Additionally, he had had a poor appetite for 4 d. He had been on aspirin for 2 years due to underlying hypertension. Initial simple radiography revealed a slight ileus. The laboratory findings were as follows: white blood cell count, 15.5 × 103/µL (normal range 4.8 × 103–10.8 × 103); hemoglobin, 9.4 g/dL; aspartate aminotransferase/alanine transferase, 423/348 U/L; total bilirubin/direct bilirubin, 4.45/3.26 mg/dL; -GTP , 639 U/L (normal range 5–61 U/L); and C-reactive protein, 12.32 mg/dL (0–0.3). Abdominal computed tomography showed a distended gallbladder with edematous wall change and a 55 mm × 40 mm hematoma. Dilatation was observed in both the intrahepatic and common bile duct areas. Antibiotic treatment was initiated, and ERCP was performed, with hemobilia found during treatment. After cannulation, the patient’s symptoms were relieved, and after conservative management, the patient was discharged with no further complications. After 1-month follow-up, the gallbladder hematoma was completely resolved.
CONCLUSION In the case of traumatic injury to the gallbladder, conservative treatment is feasible even in the presence of hematoma.
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Affiliation(s)
- Hyunseok Jang
- Division of Trauma, Department of Surgery, Chonnam National University Medical School and Hospital, Dong-gu 61469, Gwangju, South Korea
| | - Chang-Hwan Park
- Department of Internal Medicine, Chonnam National University Medical School and Hospital, Dong-gu 61469, Gwangju, South Korea
| | - Yunchul Park
- Division of Trauma, Department of Surgery, Chonnam National University Medical School and Hospital, Dong-gu 61469, Gwangju, South Korea
| | - Euisung Jeong
- Division of Trauma, Department of Surgery, Chonnam National University Medical School and Hospital, Dong-gu 61469, Gwangju, South Korea
| | - Naa Lee
- Division of Trauma, Department of Surgery, Chonnam National University Medical School and Hospital, Dong-gu 61469, Gwangju, South Korea
| | - Jungchul Kim
- Division of Trauma, Department of Surgery, Chonnam National University Medical School and Hospital, Dong-gu 61469, Gwangju, South Korea
| | - Younggoun Jo
- Division of Trauma, Department of Surgery, Chonnam National University Medical School and Hospital, Dong-gu 61469, Gwangju, South Korea
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Pham HD, Nguyen TC, Huynh QH. Diagnostic imaging in a patient with an isolated blunt traumatic gallbladder injury. Radiol Case Rep 2021; 16:2557-2563. [PMID: 34306287 PMCID: PMC8283152 DOI: 10.1016/j.radcr.2021.06.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 06/13/2021] [Accepted: 06/14/2021] [Indexed: 12/08/2022] Open
Abstract
Isolated gallbladder injuries are very uncommon in blunt abdominal trauma due to its small size. Further, they are well protected by the surrounding liver, omentum, and the rib cage. A case of traumatic gallbladder injury in a 47-year-old man with progressive right hypochondrial pain is presented. The gallbladder injury was caused due to a blunt abdominal trauma after a motor vehicle accident. The patient had a history of chronic alcoholism and narcotics abuse. The patient was also human immunodeficiency virus-positive and was on stable treatment for tuberculosis. A diagnosis of gallbladder contusion with intramural dissection was made after an ultrasound and computed tomography scan. However, the patient refused surgery and thus, an ultrasound-guided percutaneous transhepatic drainage of the gallbladder was performed as a temporary treatment. Subsequently, a successful cholecystectomy was performed. Isolated traumatic gallbladder injury has been reviewed due to the rarity of this condition and the diagnostic challenges it poses.
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Affiliation(s)
- Hong Duc Pham
- Radiology Department, Ha Noi Medical University, Ha Noi, Vietnam.,Radiology Department, Saint-Paul Hospital, Ha Noi, Vietnam
| | | | - Quang Huy Huynh
- Radiology Department, Pham Ngoc Thach University of Medicine, 2 Duong Quang Trung street, District 10, Ho Chi Minh city 700000, Vietnam.,Radiology Department, Trung Vuong Hospital, Ho Chi Minh city, Vietnam
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Issa I, Modica Alameddine V, Fadous Khalife MC, Al Ojaimi M, Ghorayeb Z. Isolated and stable gallbladder perforation in a 5 year old child after blunt abdominal trauma. Trauma Case Rep 2017; 9:27-29. [PMID: 29644320 PMCID: PMC5883222 DOI: 10.1016/j.tcr.2017.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2017] [Indexed: 10/25/2022] Open
Abstract
Isolated gallbladder injury, secondary to a blunt abdominal trauma, is a rare finding in children. The presence of vague symptoms and the unknown dynamic of the trauma may increase the diagnostic challenge especially in pediatrics. A conservative management has been proposed in some particular cases in adults, but remains controversial in children. We report a case of a 5 year old boy who presented an isolated gallbladder lesion secondary to a blunt abdominal trauma. The surgical treatment was delayed for non-medical reasons, which gave us the possibility to try a conservative approach.
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Affiliation(s)
- I Issa
- Department of Pediatrics & Pediatric Surgery, UH Notre Dame De Secours, Jbeil, Lebanon.,Holy Spirit University of Kaslik, Lebanon
| | - V Modica Alameddine
- Department of Pediatrics & Pediatric Surgery, UH Notre Dame De Secours, Jbeil, Lebanon.,Holy Spirit University of Kaslik, Lebanon
| | - M C Fadous Khalife
- Department of Pediatrics & Pediatric Surgery, UH Notre Dame De Secours, Jbeil, Lebanon.,Holy Spirit University of Kaslik, Lebanon
| | | | - Z Ghorayeb
- Department of Pediatrics & Pediatric Surgery, UH Notre Dame De Secours, Jbeil, Lebanon.,Holy Spirit University of Kaslik, Lebanon
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