Traumatic rupture of the gallbladder

Mitchell J. Mendrek, MD; Juan R. Rodriguez, MD; Mardjohan Hardjasudarma, MD

View content online at: http://www.appliedradiology.com/Issues/2006/09/Cases/Traumatic-rupture-of-the-gallbladder.aspx

Abstract:  Traumatic rupture of the gallbladder Contrast-enhanced CT shows the presence of pericholecystic fluid (Figure 1) as well as fluid in hepatorenal fossa (Figure 2). The gallbladder presents an ill-defined contour and appears partially contracted; an increase in attenuation in its lumen is compatible wi

Loading...
Diagnosis
Traumatic rupture of the gallbladder

Findings
Contrast-enhanced CT shows the presence of pericholecystic fluid (Figure 1) as well as fluid in hepatorenal fossa (Figure 2). The gallbladder presents an ill-defined contour and appears partially contracted; an increase in attenuation in its lumen is compatible with blood (Figure 3). The rest of the examination was unremarkable, with the exception of the previous known posterior right hip dislocation.

CASE FOLLOW-UP

The patient was taken to the operating room for an exploratory laparotomy based on symptoms and positive peritoneal signs as well as imaging findings. On entering the peritoneum, a significant amount of bile was found. An approximately 4-cm laceration was noted in the inferior surface of the gallbladder (Figure 4). The gallbladder was surgically removed. There was no other traumatic injury in the abdomen. The postoperative course was uneventful. The patient was discharged 5 days after the accident in stable condition.

  1. Soderstrom CA, Maekawa K, DuPriest RW Jr, Cowley RA. Gallbladder injuries resulting from blunt abdominal trauma: An experience and review. Ann Surg. 1981;193:60-66.
  2. Penn I. Injuries to the gall-bladder. Br J Surg. 1962;49:636-641.
  3. Smith SW, Hastings TN. Traumatic rupture of the gallbladder. Ann Surg.1954;139:517-520.
  4. Hicks JA. Case of traumatic perforation of gallbladder in child of 3 years. Br J Surg.1944;31:305.
  5. Grimes OF, Steinbach HL. Traumatic cholecystocutaneous fistula.Arch Surg.1955;71:68-70.
  6. Griffith CDM, Saunders JH. Cholecystoduodenocolic fistula following abdominal trauma. Br J Surg. 1982;69:99-100.
  7. Gottesman L, Marks RA, Khoury PT, et al. Diagnosis of isolated perforation of the gallbladder following blunt trauma using sonography and CT. J Trauma. 1984;24:280-281.
  8. Jeffrey RB Jr, Federle MP, Laing FC, Wing VW. Computed tomography of blunt trauma to the gallbladder.J Comput Assist Tomogr.1986;10:756-758.
  9. Ball DS, Friedman AC, Radecki PD, Caroline DF. Avulsed gallbladder: CT appearance.J Comput Assist Tomogr.1988;12:538-539.
  10. Carrillo EH, Lottenberg L, Saridakis A. Blunt traumatic injury of the gallbladder. J Trauma.2004;57:408-409.
  11. Erb RE, Mirvis SE, Shanmuganathan K. Gallbladder injury secondary to bunt trauma: CT findings.J Comput Assist Tomogr.1994;18:778-784.
  12. Smith EH, Soderberg CH Jr. Traumatic rupture of the gallbladder.RI Med J.1964;47:29-30.