Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
권호 표지
DOI QR코드

DOI QR Code

Non-Operative Management of Traumatic Gallbladder Bleeding with Cystic Artery Injury: A Case Report

  • Kim, Tae Hoon (Department of Emergency Medicine, Trauma Center, Wonkwang University Hospital)
  • Received : 2021.01.08
  • Accepted : 2021.07.05
  • Published : 2021.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

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.

Keywords

References

  1. Egawa N, Ueda J, Hiraki M, Ide T, Inoue S, Sakamoto Y, et al. Traumatic gallbladder rupture treated by laparoscopic cholecystectomy. Case Rep Gastroenterol 2016;10:212-7. https://doi.org/10.1159/000437046
  2. Hamilton C, Carmichael S, Bernard A. Laparoscopic cholecystectomy for traumatic gallbladder perforation. J Surg Case Rep 2012;2012:13. https://doi.org/10.1093/jscr/2012.6.13
  3. Philipoff AC, Lumsdaine W, Weber DG. Traumatic gallbladder rupture: a patient with multiple risk factors. BMJ Case Rep 2016;2016:bcr2016216811. https://doi.org/10.1136/bcr-2016-216811
  4. Salzman S, Lutfi R, Fishman D, Doherty J, Merlotti G. Traumatic rupture of the gallbladder. J Trauma 2006;61:454-6. https://doi.org/10.1097/01.ta.0000231456.20389.5e
  5. Huang CC, Lo HC, Tzeng YM, Huang HH, Chen JD, Kao WF, et al. Percutaneous transhepatic gall bladder drainage: a better initial therapeutic choice for patients with gall bladder perforation in the emergency department. Emerg Med J 2007;24:836-40. https://doi.org/10.1136/emj.2007.052175
  6. Latremouille R, Martinez-Quinones P, Lopez NS, White CQ. Gallbladder necrosis after right hepatic artery embolization due to traumatic hepatic injury. Am Surg 2018;84:e237-8. https://doi.org/10.1177/000313481808400711
  7. Sharma O. Blunt gallbladder injuries: presentation of twenty-two cases with review of the literature. J Trauma 1995;39:576-80. https://doi.org/10.1097/00005373-199509000-00029
  8. Sondenaa K, Horn A, Nedrebo T. Diagnosis of blunt trauma to the gallbladder and bile ducts. Eur J Surg 2000;166:903-7. https://doi.org/10.1080/110241500447326
  9. Zerem E, Omerovic S, Kunosic S. Sonographically guided percutaneous treatment of liver abscesses in critically Ill patients. J Clin Ultrasound 2014;42:527-33. https://doi.org/10.1002/jcu.22190
  10. Misselbeck TS, Teicher EJ, Cipolle MD, Pasquale MD, Shah KT, Dangleben DA, et al. Hepatic angioembolization in trauma patients: indications and complications. J Trauma 2009;67:769-73. https://doi.org/10.1097/TA.0b013e3181b5ce7f
  11. Green CS, Bulger EM, Kwan SW. Outcomes and complications of angioembolization for hepatic trauma: a systematic review of the literature. J Trauma Acute Care Surg 2016;80:529-37. https://doi.org/10.1097/TA.0000000000000942