title: Isolated complete avulsion of the gallbladder (near traumatic cholecystectomy): a case report and review of the literature.
abstract: BACKGROUND
  Injury of the gallbladder after blunt abdominal trauma is an unusual finding; the reported incidence is less than 2%. Three groups of injuries are described: simple contusion, laceration, and avulsion, the last of which can be partial, complete, or total traumatic cholecystectomy.
  
  
  METHODS
  A case of isolated complete avulsion of the gallbladder (near traumatic cholecystectomy) from its hepatic bed in a 46-year-old Caucasian man without any other sign of injury is presented. The avulsion was due to blunt abdominal trauma after a car accident. The rarity of this injury and the stable condition of our patient at the initial presentation warrant a description. The diagnosis was made incidentally after a computed tomography scan, and our patient was treated successfully with ligation of the cystic duct and artery, removal of the gallbladder, coagulation of the bleeding points, and placement of a drain.
  
  
  CONCLUSIONS
  Early diagnosis of such injuries is quite difficult because abdominal signs are poor, non-specific, or even absent. Therefore, a computed tomography scan should be performed when the mechanism of injury is indicated.
authors.affiliation: Second Surgical Propedeutical Department, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Konstantinoupoleos 49, 546 42 Thessaloniki, Greece. miltiadislalountas@yahoo.gr.
authors.forename: Theodoros E
authors.initials: TE
authors.lastname: Pavlidis
authors.forename: Miltiadis A
authors.initials: MA
authors.lastname: Lalountas
authors.forename: Kyriakos
authors.initials: K
authors.lastname: Psarras
authors.forename: Nikolaos G
authors.initials: NG
authors.lastname: Symeonidis
authors.forename: Anastasios
authors.initials: A
authors.lastname: Tsitlakidis
authors.forename: Efstathios T
authors.initials: ET
authors.lastname: Pavlidis
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Ballas
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Flaris
authors.forename: Georgios N
authors.initials: GN
authors.lastname: Marakis
authors.forename: Athanassios K
authors.initials: AK
authors.lastname: Sakantamis