Nishiwaki M, Ashida H, Nishimura T, Kimura M, Yagyu R, Nishioka A, Utsunomiya J, Yamamura T
Second Department of Surgery, Hyogo College of Medicine, Nishinomiya, Japan.
J Gastroenterol. 1999 Apr;34(2):282-5. doi: 10.1007/s005350050258.
We report a case of intra-gallbladder hemorrhage secondary to blunt abdominal trauma in a patient with liver cirrhosis. A 58-year-old man was admitted to a local hospital with persistent right upper quadrant abdominal pain. Anemia was detected, and computed tomography (CT) revealed a high-density mass in the gallbladder lumen. He was transferred to our hospital because a gallbladder tumor was suspected. He had a history of habitual alcohol abuse and had sustained blunt abdominal trauma in the right upper quadrant 29 days before admission to our hospital (4 days before to the admission local hospital). The intra-gallbladder high-density mass depicted on the CT scan, observed as non-shadowing low-level echoes, was deemed to represent a blood clot on ultrasonography (US) performed 31 days after the trauma. US-guided percutaneous transhepatic gallbladder aspiration and cholecystography confirmed the presence of an old blood clot in the lumen. Because of the patient's persistent pain, a cholecystectomy was performed. The distended gallbladder was filled with old clotted blood.
我们报告一例肝硬化患者因腹部钝性创伤继发胆囊内出血的病例。一名58岁男性因持续性右上腹腹痛入住当地医院。检测发现贫血,计算机断层扫描(CT)显示胆囊腔内有高密度肿块。因怀疑胆囊肿瘤,他被转至我院。他有习惯性酗酒史,在入住我院前29天(入住当地医院前4天)右上腹遭受钝性腹部创伤。创伤后31天进行的超声检查(US)显示,CT扫描所见胆囊内高密度肿块表现为无回声的低水平回声,被认为是血凝块。超声引导下经皮经肝胆囊穿刺抽吸及胆囊造影证实腔内存在陈旧性血凝块。由于患者持续疼痛,遂行胆囊切除术。扩张的胆囊内充满了陈旧性凝血块。