Isolated traumatic rupture of the gallbladder

Abstract

Gallbladder injury resulting from blunt abdominal trauma is rare, being found in only about 2% of patients who undergo laparotomy for abdominal trauma. Its small size and anatomic location—partially embedded in the liver tissue, surrounded by the omentum and intestines, and overlaid by the rib cage—provides good protection.Diagnosis can be difficult, and delay may result in the development of weight loss, nausea, vomiting, abdominal distension, jaundice, ascites, and abdominal pains. Delayed imaging with computed tomography can aid in diagnosis, especially in differentiating benign processes from true gallbladder injuries.Treatment for gallbladder injury is most commonly cholecystectomy. Mortality rates in patients with gallbladder injuries are related to associated injuries, including cardiac, thoracic or intra-abdominal hemorrhage, or multi-organ failure and/or brain damage. In isolated gallbladder injury, the prognosis is good.

Delayed presentation of isolated gallbladder rupture after blunt abdominal trauma

“…In blunt abdominal trauma, gallbladder rupture is found in approximately 2% of laparotomies [2]. Due to the small size and the anatomic location of gallbladder (partially embedded in the liver tissue, surrounded by the omentum and intestines, and overlaid by the rib cage), the isolated rupture is even much rarer [5]. Most commonly associated injuries include liver or splenic laceration, and mesenteric tears [6].…”

“…Men are more commonly affected with an average age of 27 years [5]. There is a high probability for kids to be affected due of their vulnerability to direct abdominal trauma as well as their poor anterior abdominal wall muscular development [1].…”

“…Three predisposing factors of gallbladder rupture that are frequently described: thin-walled normal gallbladder, postprandial distended gallbladder, alcohol ingestion, and gallbladder malposition [5,7]. Chronically diseased gallbladder wall is less likely to be injured [5].…”

“…Three predisposing factors of gallbladder rupture that are frequently described: thin-walled normal gallbladder, postprandial distended gallbladder, alcohol ingestion, and gallbladder malposition [5,7]. Chronically diseased gallbladder wall is less likely to be injured [5]. Cirrhotic liver is reported as a probable risk factor which may exacerbate shear forces in the gallbladder fossa due to the difference in mass between these two organs [8,9].…”

Pediatric traumatic gallbladder rupture

“…CT scans are typically the imaging modality of choice following abdominal trauma in a stable patient; however, diagnosing gallbladder injury can be challenging [ 5 ]. An anomalous contour of the gallbladder wall, collapsed lumen or presence of pericholecystic fluid on these scans strongly suggests primary injury to the gallbladder [ 4 ].…”