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.

Figure 1

59-year-old male with perforation of the gallbladder. Findings: Axial (A) and coronal (B) contrast-enhanced CT images of the abdomen through the gallbladder reveal gallbladder wall thickening and focal mural disruption. Technique: Selected axial and coronal CT images of the abdomen and pelvis with IV contrast.

Figure 2

59-year-old male with perforation of the gallbladder. Findings: Axial contrast-enhanced CT image of the abdomen through the gallbladder in the delayed phase demonstrates increasing density within the gallbladder representing accumulating blood within the gallbladder. Technique: Axial CT image of the abdomen and pelvis with IV contrast performed in the delayed phase.