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钝性腹部创伤导致孤立性浆膜下胆囊损伤继发胆汁性腹膜炎——病例报告

Choleperitoneum secondary to isolated subserosal gallbladder injury due to blunt abdominal trauma - A case report.

作者信息

Reitz Marianne Marchini, Araújo Júlio Muniz, de Souza Guilherme Henrique Novaes, Gagliardi Danielle Pieretti, de Toledo Flávius Vinícius Teixeira, Ribeiro Júnior Marcelo Augusto Fontenelle

机构信息

Hospital Municipal Dr. José de Carvalho Florence, General Surgery Department, São José dos Campos, 12220-280 São Paulo, Brazil.

Humanitas - Faculdade de Ciências Médicas de São José dos Campos, São José dos Campos, 12220-611 São Paulo, Brazil.

出版信息

Trauma Case Rep. 2022 Jul 8;41:100674. doi: 10.1016/j.tcr.2022.100674. eCollection 2022 Oct.

Abstract

When dealing with rare traumatic injuries, surgeons might have difficulty diagnosing them and choosing the most appropriate management when no consensus exist on the best course of action. In such circumstances, drawing on the experience of colleagues can be of great value. Traumatic injuries of the gallbladder are unusual and might not be readily identifiable neither in imaging studies nor during surgery. Retrograde cholangiography plays an important role in correctly diagnosing these injuries and guiding decision-making. We report a case of a subserosal perforation due to blunt trauma to the abdomen, which was identified intraoperatively after a transcystic retrograde cholangiogram was performed and managed successfully with formal cholecystectomy.

摘要

在处理罕见的创伤性损伤时,当对于最佳行动方案没有达成共识时,外科医生可能难以对其进行诊断并选择最合适的治疗方法。在这种情况下,借鉴同事的经验可能会有很大价值。胆囊创伤性损伤并不常见,在影像学检查或手术过程中可能都不容易识别。逆行胆管造影在正确诊断这些损伤和指导决策方面发挥着重要作用。我们报告一例因腹部钝性创伤导致的浆膜下穿孔病例,该病例在进行经胆囊逆行胆管造影后于术中被发现,并通过正规胆囊切除术成功治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dde4/9283662/9487a709a286/gr1.jpg

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