Pavlidis Theodoros E, Lalountas Miltiadis A, Psarras Kyriakos, Symeonidis Nikolaos G, Tsitlakidis Anastasios, Pavlidis Efstathios T, Ballas Konstantinos, Flaris Nikolaos, Marakis Georgios N, Sakantamis Athanassios K
Second Surgical Propedeutical Department, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Konstantinoupoleos 49, 546 42 Thessaloniki, Greece.
J Med Case Rep. 2011 Aug 18;5:392. doi: 10.1186/1752-1947-5-392.
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.
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.
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.
钝性腹部创伤后胆囊损伤是一种不常见的情况；报道的发生率低于2%。损伤分为三组：单纯挫伤、裂伤和撕脱伤，其中最后一种可分为部分性、完全性或完全创伤性胆囊切除术。
本文介绍了一名46岁白种男性，其胆囊从肝床完全撕脱（近乎创伤性胆囊切除术），且无任何其他损伤迹象。撕脱伤是由车祸后的钝性腹部创伤引起的。这种损伤的罕见性以及我们患者初始表现时的稳定状况值得描述。诊断是在计算机断层扫描后偶然发现的，我们的患者通过结扎胆囊管和动脉、切除胆囊、止血点凝血以及放置引流管成功治愈。
此类损伤的早期诊断相当困难，因为腹部体征不明显、不具特异性甚至不存在。因此，当有损伤机制提示时，应进行计算机断层扫描。
