Traumatic injury to the extrahepatic biliary system is rare and usually diagnosed at laparotomy when it is
associated with other visceral injuries. Isolated gallbladder rupture due to blunt abdominal trauma is even
rarer. The clinical presentation of gallbladder injury is variable, resulting in a delay in diagnosis and
treatment. Awareness to the possibilty of trauma to the extrahepatic biliary system enables early surgical
intervention and eliminates the high morbidity associated with delated diagnosis.
A 5 year old child with isolated gallbladder rupture caused by blunt abdominal trauma is presented.
This series clearly demonstrates poor rates of surgical salvage, which we mainly attribute to delays in parental response and in primary physician referral to the hospital. Parents, who have a pivotal role in early diagnosis, were usually unaware of this urological emergency, and some were surprisingly unaware of the presence of cryptorchidism. By increasing the awareness regarding this entity among members of the medical community and parents, we hope that torsion of the cryptorchid testis (literally, "hidden testis") will no longer necessarily be synonymous with "crypt-torsion" ("hidden torsion").
Our three-sectional view of the neck and upper chest is useful for in utero detection of esophageal pouch that may enhance the prenatal diagnosis of EA. The positive predictive value for prenatal ultrasound for detecting EA is 100% with a sensitivity of 80%.
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