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Case Reports
Penetrating gallbladder injury in a pediatric patient: a case report
Nelimar Cruz-Centeno, Shai Stewart, Derek R. Marlor, Charlene Dekonenko, Richard J. Hendrickson
J Trauma Inj. 2023;36(3):295-297.   Published online July 5, 2023
DOI: https://doi.org/10.20408/jti.2023.0008
  • 662 View
  • 21 Download
AbstractAbstract PDF
Penetrating gallbladder injuries are uncommon in the pediatric population. The treatment varies according to the severity of the injury and the patient’s hemodynamics. We present the case of an 11-year-old male with an accidental pellet gunshot wound to the right upper abdomen that resulted in a grade III liver laceration and damage to the anterior gallbladder wall. The patient underwent laparoscopic cholecystectomy with drain placement. Postoperative radiography of the surgical specimen confirmed the presence of the pellet in the gallbladder. The patient recovered uneventfully and was discharged home on postoperative day 3. Laparoscopic cholecystectomy is a feasible treatment option for penetrating gallbladder injuries in hemodynamically stable patients.
Summary
Delayed bladder perforation due to screw loosening after pelvic ring injury surgery: a case report
Hyun-Chul Shon, Ho-Won Kang, Eic-Ju Lim, Jae-Young Yang
J Trauma Inj. 2022;35(1):51-55.   Published online December 22, 2021
DOI: https://doi.org/10.20408/jti.2021.0054
  • 2,356 View
  • 85 Download
AbstractAbstract PDF
Pelvic ring injuries have high mortality and morbidity rates, and they are difficult to treat because accompanying injuries to the pelvic organs, genitourinary organs, and neurovascular tissues are common. Genitourinary injuries are common comorbid injuries that have been reported to occur in 5% to 6% of all pelvic ring injuries. However, these injuries usually occur simultaneously with the pelvic ring injury, whereas relatively little research has dealt with genitourinary injuries that occur after treatment of a pelvic ring injury. To the best of our knowledge, only three cases of delayed bladder perforation due to screw loosening after symphyseal plate fixation in anterior pelvic ring injury have been reported worldwide, and no such cases have yet been reported in Korea. Since the authors experienced this very rare complication after pelvic ring surgery, we report this case along with a literature review.
Summary
Complete Transection of the Cystic Duct and Artery after Blunt Trauma: A Case Report
Sung Hoon Cho, Kyoung Hoon Lim
J Trauma Inj. 2021;34(4):294-298.   Published online December 16, 2021
DOI: https://doi.org/10.20408/jti.2021.0097
  • 2,743 View
  • 80 Download
  • 1 Citations
AbstractAbstract PDF

Extrahepatic biliary tract and gallbladder injuries following blunt abdominal trauma are uncommon. Traumatic cystic duct transection is even rarer, which has frequently caused missed diagnosis and delayed treatment. An 18-year-old female patient with no past medical history was transferred to the Trauma Center of Kyungpook National University Hospital after falling from a height of approximately 20 meters. She became hemodynamically stable after initial resuscitation, and initial contrast-enhanced abdominal computed tomography (CT) showed right kidney traumatic infarction and multiple intrahepatic contusions with minimal fluid collection but no extravasation of the contrast. She was admitted to the intensive care unit. On the second day of hospitalization, her abdomen became distended, with follow-up CT showing a large collection of intra-abdominal fluid. Laparoscopic exploration was then performed, which revealed devascularization of the gallbladder with complete transection of the cystic duct and artery. Laparoscopic cholecystectomy was performed, as well as primary closure of the cystic duct orifice on the common bile duct using a 4-0 Prolene suture. After surgery, no clinical evidence of biliary leakage or common bile duct stricture was observed.

Summary

Citations

Citations to this article as recorded by  
  • A Rare Complication of Percutaneous Transhepatic Gallbladder Drainage
    Yang-Yuan Chen, Chih-Hsuan Chen, Yung-Fang Chen
    Gastroenterology.2022; 163(5): e29.     CrossRef
Non-Operative Management of Traumatic Gallbladder Bleeding with Cystic Artery Injury: A Case Report
Tae Hoon Kim
J Trauma Inj. 2021;34(3):208-211.   Published online August 19, 2021
DOI: https://doi.org/10.20408/jti.2021.0003
  • 2,728 View
  • 67 Download
AbstractAbstract PDF

Gallbladder injuries are rare in cases of blunt abdominal trauma and are usually associated with damage to other internal organs. If the physician does not suspect gallbladder injury and check imaging studies carefully, it may be difficult to distinguish a gallbladder injury from gallbladder stone, hematoma, or bleeding. Therefore, in order not to miss the diagnosis, the clinical findings and correlation should be confirmed. In the present case, a 60-year-old male presented to a local trauma center complaining of pain in the upper right quadrant and chest wall following a motor vehicle collision. Abdominal computed tomography (CT) showed a hepatic laceration and hematoma in the parenchyma in segments 4, 5, and 6 and active bleeding in the lumen of the gallbladder. Traumatic gallbladder injuries generally require surgery, but in this case, non-operative management was possible with cautious follow-up consisting of abdominal CT and angiography with repeated physical examinations and hemodynamic monitoring in the intensive care unit.

Summary
Laparoscopy in Blunt Abdominal Trauma: Diaphragmatic and Bladder Lacerations Repair
Ruben Martins, Martins dos Santos, Tatiana Revez
J Trauma Inj. 2019;32(3):176-180.   Published online September 30, 2019
DOI: https://doi.org/10.20408/jti.2019.019
  • 3,076 View
  • 48 Download
AbstractAbstract PDF

The growing use of laparoscopy in elective surgery has led to its increase utilization in emergency surgery. However, the employment of laparoscopy in abdominal trauma is still unusual. Here in we report a case of a patient with blunt abdominal trauma that resulted in a combination of exceptional traumatic lesions, diaphragmatic and bladder lacerations. Both injuries were diagnosed and successfully resolved by laparoscopy. The report of this type of lesions and resolution is extremely rare, being this the second case described in the international literature. This article intends to show that laparoscopy may not only be used as a diagnostic tool, but also as a therapeutic instrument in selected cases of blunt abdominal trauma.

Summary
Pseudo-renal Failure Caused by Urinary Bladder Rupture in Multiple Trauma Patient
Jihoon Jang, Kyoung Hoon Lim
J Trauma Inj. 2016;29(4):191-194.   Published online December 31, 2016
DOI: https://doi.org/10.20408/jti.2016.29.4.191
  • 2,446 View
  • 21 Download
AbstractAbstract PDF
Pseudo-renal failure presents with renal failure characteristics, such as hypercreatininemia and hyperkalemia without a change in glomerular filtration rate or structure of the kidney. Pseudo-renal failure due to trauma is difficult to diagnose, because symptoms are non-specific and other factors may cause hypercreatininemia and hyperkalemia. In a trauma patient, especially one with pelvic injury, the abrupt elevation of potassium, blood urea nitrogen, and creatinine levels without previous medical history is a key feature in the diagnosis of urinary ascites. We report a case of pseudo-renal failure caused by intraperitoneal bladder rupture in a multiple trauma patient.
Summary
Original Article
Relation between Location of Pelvic bone Fractures and the Injury to the Urinary bladder, Urethra or Lower gastrointestinal tract
Chang Ho Kim, Jung Bae Park, Hyun Wook Ryoo, Kang Suk Seo, Jun Seok Seo, Jae Myung Chung, Dong Wook Je, Ae Jin Sung
J Korean Soc Traumatol. 2007;20(2):90-95.
  • 1,020 View
  • 3 Download
AbstractAbstract PDF
PURPOSE
This research was conducted to study whether the specific location of pelvic-bone fractures could increase the risk for injury to the urinary bladder, urethra, or lower gastrointestinal tract.
METHODS
We retrospectively reviewed the data of 234 patients with pelvic-bone fractures who visited the emergency department of Kyungpook National University Hospital from January 2004 to December 2006. The location of the pelvic-bone fracture was divided into 8 parts. The association of fracture location with injury to the urinary bladder, urethra, or lower gastrointestinal tract was analyzed with Fisher's-exact test and multiple logistic regression.
RESULTS
Nineteen(19) patients had urinary bladder injury, 8 had urethral injury, and 9 had lower gastrointestinal tract injury. The following fracture locations were found to be significant; urinary bladder: sacroiliac (SI) joint (p<0.001), symphysis pubis (p=0.011), and sacrum (p=0.005); urethra: SI joint (p=0.020); lower gastrointestinal tract: symphysis pubis (p=0.028). After the multiple logistic regression analysis, the primary and the independent predictors for each of the injuries were as follows; urinary bladder: sacroiliac joint (p=0.000, odds ratio [OR]=10.469); lower gastrointestinal tract: symphysis pubis (p=0.037, OR=7.009).
CONCLUSION
Consideration of further workup for injuries to the lower gastrointestinal and urinary tract is needed for some locations of pelvic-bone fractures because certain pelvic-bone fracture locations, especially the sacroiliac joint and the symphysis pubis, are associated with increased risk for injury to the lower gastrointestinal and urinary tracts.
Summary
Case Report
A Case of Neobladder Rupture Following Blunt Trauma
Young Hoon Sul, Moon Haeng Lee, Sang Il Lee, Kwang Sik Cheon, In Sang Song
J Korean Soc Traumatol. 2012;25(3):101-104.
  • 1,276 View
  • 4 Download
AbstractAbstract PDF
Bladder rupture following blunt trauma is rare, and no neobladder rupture following blunt trauma has yet been reported. We present a case of neobladder rupture following blunt trauma. The patient was a 65-year-old male patient who had been treated for bladder cancer via a radical cystectomy with an orthotopic ileal neobladder four years prior to this admission, and who was admitted to our emergency department due to multiple trauma after a 1.5 m fall. Primary repair was performed for the neobladder rupture.
Summary
Original Article
Acalculous Cholecystitis Following Multiple Trauma with Fractures
Ki Hoon Kim, Kyu Hyouk Kyung, Jin Su Kim, Kwan U Kim, Woon Won Kim, Ji Wan Kim
J Trauma Inj. 2012;25(4):203-208.
  • 1,015 View
  • 2 Download
AbstractAbstract PDF
PURPOSE
The purpose of this study is to investigate the incidence of acalculous cholecystitis after multiple trauma with fractures and to analyze the characteristics of cholecystitis.
METHODS
We performed a retrospective study of multiple trauma patients with fractures between April 2010 and April 2012. Sixty-nine patients were identified, and the average age was 46.8(range: 15-74) years. Data were collected regarding associated injury, injury severity score (ISS), the diagnosis time after trauma, diagnostic tool, and management.
RESULTS
There were three cases(4.3%) of cholecystitis among the 69 cases, and cholecystitis was diagnosed an average of 20.7(range: 8-33) days after injury. Two patients complained of abdominal pain at diagnosis, but the other patient who had undergone surgery for small bowel perforation at the time of the injury had no abdominal pain. All three patients had abnormal liver function tests (LFTs) at diagnosis. The cholecystitis was confirmed with ultrasonography or computed tomography, and all cases were acalculous cholecystitis. At first, percutaneous transhepatic gallbladder drainage was performed; then, laparoscopic cholecystectomy (LC) was tried an average of 12(range: 11-13) days later. An laparoscopic cholecystectomy was successfully done in only one case, the other cases being converted to an open cholecystectomy due to severe inflammation.
CONCLUSION
The incidence of acaculous cholecystitis was 4.3% after multiple trauma with fractures. We should consider cholecystitis in patients with abdominal pain, fever and elevated LFTs after multiple trauma.
Summary

J Trauma Inj : Journal of Trauma and Injury