Delayed presentation of an isolated gallbladder rupture following blunt abdominal trauma: a case report

Blunt injuries to the gallbladder occur rarely, and the incidence of isolated damage to the gallbladder is even smaller. We report a case of delayed presentation of isolated rupture of the gallbladder following blunt trauma to the abdomen. A 65 year old lady presented through the Emergency Departmen...

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Bibliographic Details
Published in:Journal of medical case reports 2007-07, Vol.1 (1), p.52-52, Article 52
Main Authors: Bainbridge, Jonathan, Shaaban, Hossam, Kenefick, Nick, Armstrong, Christopher P
Format: Article
Language:English
Subjects:
Abdomen
Abdominal pain
Care and treatment
Case Report
Case studies
Complications and side effects
Diagnosis
Gallbladder
Injuries
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Summary:Blunt injuries to the gallbladder occur rarely, and the incidence of isolated damage to the gallbladder is even smaller. We report a case of delayed presentation of isolated rupture of the gallbladder following blunt trauma to the abdomen. A 65 year old lady presented through the Emergency Department with a 1 week history of blunt trauma to her abdomen. She complained of continued epigastric pain which radiated through to her back and right upper quadrant. On presentation, the patient had a low grade temperature, hypotension and mild tachycardia. Abdominal examination revealed right upper quadrant tenderness with no localised peritonism. C-reactive protein was 451. An abdominal CT showed a moderate amount of ascitic fluid in the perihepatic space. The patient underwent a laparotomy, which revealed a ruptured gallbladder with free bile. There was no evidence of any associated injuries to the surrounding organs. Partial cholecystectomy was done in view of the friable nature of the gallbladder. Post operatively, a persistent bile leak was managed successfully with endoscopic sphincterotomy and stenting. Rupture of the gallbladder due to blunt injuries to the abdomen occurs from time to time and may constitute a diagnostic challenge especially with delayed presentation. Partial cholecystectomy is a safe option in cases where friability of the wall renders formal cholecystectomy inadvisable. Endoscopic sphincterotomy and stenting is a safe and effective treatment for persistent post operative bile leaks.
ISSN:1752-1947
1752-1947
DOI:10.1186/1752-1947-1-52