Isolated perforation of the gall bladder following blunt abdominal trauma

Abstract

Summary Isolated perforation of the gall bladder as a consequence of blunt abdominal injury is rare. A single case is described which illustrates several features which may characterize this lesion.

Isolated Gall Bladder Perforation Following a Blunt Injury in the Abdomen

“…Perforations are the most commonly diagnosed gall bladder injuries, accounting for 3.2% of all the injuries [2]. Gallbladder rupture following blunt trauma in the absence of other intra-abdominal injuries is extremely rare [2,4]. The mechanism of gall bladder injury in blunt trauma involves compression and shearing forces.…”

“…The mechanism of gall bladder injury in blunt trauma involves compression and shearing forces. The factors which predispose the gall bladder to perforation in blunt trauma include a thin walled normal gall bladder, gall bladder distension and alcohol ingestion, which increase the sphincter of the oddi tone and raise the biliary tract pressure [2,4].…”

“…The [Table/ Fig-2]: CECT scan of abdomen coronal cut showed an irregularity in the gall bladder wall with pericholecystic collection (white arrow) spillage of infected bile gives rise to the picture of 'classical' biliary peritonitis with an acute onset of toxaemia and shock, and an associated very high mortality which was variously estimated to be between 30% and 90% [4]. A delay in the presentation of the injury is not unusual.…”

“…The damage to a normal, non infected gall bladder can cause the leakage of sterile bile into the abdomen. Such injures may have a delayed presentation [2,4].…”

“…Laparoscopic cholecystectomy has been advocated to be a safe and effective procedure in the diagnosis and management of traumatic gall bladder rupture. However, in the cases in which there is an uncertainty in the diagnosis, exploratory laparotomy is the safest option [1][2][3][4].…”