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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
  • 599 View
  • 19 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
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
  • 2,615 View
  • 79 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
  • 2,642 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
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.
  • 994 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