title: [Isolated injury of the gallbladder. A rare cause of hemorrhagic shock after blunt abdominal trauma in a patient with liver cirrhosis].
abstract: Isolated injuries to the gallbladder are extremely rare in blunt abdominal trauma, with a reported incidence of less than 2%. We report a case with partial avulsion of the gallbladder and subsequent hemorrhagic shock in a patient with liver cirrhosis. Although the gallbladder injury was demonstrated on CT images (with contrast enhancement in the bed of the gallbladder), the correct diagnosis was not established preoperatively. Emergency laparotomy revealed partial avulsion of the gallbladder and the underlying condition of severe liver cirrhosis with ascites. We estimate that the gallbladder avulsion occurred due to compressional waves of the ascites (during blunt abdominal injury) which may have sheared off the gallbladder from the cirrhotic liver. The patient received cholecystectomy, which is recommended as standard in case of gallbladder injury.
authors.affiliation: Abteilung für Unfallchirurgie der Universität zu Szeged, Hungary. sandorlaszlo@trauma.szote.u-szeged.hu
authors.forename: L
authors.initials: L
authors.lastname: Sandor
authors.forename: L
authors.initials: L
authors.lastname: Kiss
mesh_terms: D000007:Abdominal Injuries / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D002763:Cholecystectomy; D003937:Diagnosis, Differential; D005704:Gallbladder / Q000293:injuries*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012421:Rupture; D012771:Shock, Hemorrhagic / Q000209:etiology* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000175:diagnosis / Q000601:surgery