Isolated complete avulsion of the gallbladder (near traumatic cholecystectomy): a case report and review of the literature

Abstract

IntroductionInjury of the gallbladder after blunt abdominal trauma is an unusual finding; the reported incidence is less than 2%. Three groups of injuries are described: simple contusion, laceration, and avulsion, the last of which can be partial, complete, or total traumatic cholecystectomy.Case presentationA case of isolated complete avulsion of the gallbladder (near traumatic cholecystectomy) from its hepatic bed in a 46-year-old Caucasian man without any other sign of injury is presented. The avulsion was due to blunt abdominal trauma after a car accident. The rarity of this injury and the stable condition of our patient at the initial presentation warrant a description. The diagnosis was made incidentally after a computed tomography scan, and our patient was treated successfully with ligation of the cystic duct and artery, removal of the gallbladder, coagulation of the bleeding points, and placement of a drain.ConclusionsEarly diagnosis of such injuries is quite difficult because abdominal signs are poor, non-specific, or even absent. Therefore, a computed tomography scan should be performed when the mechanism of injury is indicated.

Isolated traumatic rupture of the gallbladder

“…It is partially embedded in the liver tissue, surrounded by the omentum and intestines, and overlaid by the rib cage ( 1 ). Because of this protection, gallbladder injuries are usually associated with injury of other abdominal organs, especially the liver ( 1 , 2 ), making isolated gallbladder injury an even rarer occurrence ( 2 , 3 ). Motor vehicle collisions are the most common cause of gallbladder injury, due to blunt abdominal trauma ( 1 ).…”

“…Motor vehicle collisions are the most common cause of gallbladder injury, due to blunt abdominal trauma ( 1 ). Predisposing factors to gallbladder injury include a thin-walled normal gallbladder, a distended gallbladder, and alcohol ingestion ( 3 ), while a fibrotic thickened, chronically inflamed gallbladder is less likely to be injured ( 4 ). Males are more commonly affected, with 73–89% of patients being male ( 1 , 2 ), with a median age of 27 years, though wide age ranges have been reported ( 2 , 4 ).…”

Giant biloma as a result of a blunt abdominal trauma: A case report

“…Its incidence in patients with abdominal blunt trauma is around 2% (1). The swelling or distension of the gallbladder wall and alcohol consumption are the main risk factors, since both are associated with an increased biliary tract pressure (2). They can be classified as contusion, perforation and avulsion, which can be partial when there is no bile duct or vessel damage or complete when both structures are thorn, producing the so-called "traumatic cholecystectomy" (3).…”

Ruptured Gall Bladder containing Stones following Blunt Trauma Abdomen: A Rare Presentation of Hemodynamic Instability

“…Signs of gallbladder injury are pericholecystic fluid, an ill-defined contour of the gallbladder wall, a mass effect on the duodenum, highattenuation intraluminal material (blood), a thickened gallbladder wall, and a collapsed gallbladder in a fasting patient. 10 The treatment of gall bladder injuries is cholecystectomy as supported in literature. 1,3,6 However, less severe injuries like contusions and partial avulsions can sometimes be observed.…”