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孤立性创伤性胆囊损伤:1例罕见病例

Isolated Traumatic Gallbladder Injury: A Rare Case.

作者信息

Shah Aashka, Cho Timothy, Bokhari Faran

机构信息

Surgery, Carle Illinois College of Medicine, Urbana, USA.

General Surgery, Carle Foundation Hospital, Urbana, USA.

出版信息

Cureus. 2023 Aug 23;15(8):e43982. doi: 10.7759/cureus.43982. eCollection 2023 Aug.

Abstract

The prevalence of gallbladder injury in a traumatic event is rare, occurring in only 1.9%-2.0% of all abdominal traumas. Isolated gallbladder injuries, without any damage to surrounding organs or tissues, are even less common. Presenting symptoms are often nonspecific, and imaging modalities of ultrasound (US) and CT are usually relied upon to diagnose gallbladder injury accurately. Identifying and strategically treating cases of gallbladder injury, through reviewing this case report, are important for patient outcomes. We present a case of isolated gallbladder injury in a 27-year-old male after sustaining blunt-force abdominal trauma from a snowmobile injury. The patient presented to the emergency department (ED) three days after the initial injury with complaints of significant abdominal pain associated with eating solid food. Upon workup, he was found to have an isolated traumatic gallbladder injury for which a laparoscopic cholecystectomy was performed, and the patient was discharged with no complications. Gallbladder injury, with no evidence of other intra-abdominal injuries, is rare and often not considered in the differential for a trauma patient. Delayed intervention is associated with adverse patient outcomes, emphasizing the need to consider gallbladder injuries in patients presenting with abdominal pain, especially with a history of chronic alcohol use.

摘要

胆囊损伤在创伤事件中的发生率很低,仅占所有腹部创伤的1.9%-2.0%。孤立性胆囊损伤,即周围器官或组织无任何损伤的情况,更为罕见。其临床表现往往不具特异性,通常依靠超声(US)和CT等影像学检查手段来准确诊断胆囊损伤。通过回顾本病例报告,识别并合理治疗胆囊损伤病例对患者的预后至关重要。我们报告一例27岁男性患者,因雪地摩托损伤导致钝性腹部创伤后出现孤立性胆囊损伤。患者在初次受伤三天后因进食固体食物后出现严重腹痛而就诊于急诊科。经检查,发现其患有孤立性创伤性胆囊损伤,遂行腹腔镜胆囊切除术,患者术后无并发症出院。无其他腹腔内损伤证据的胆囊损伤较为罕见,在创伤患者的鉴别诊断中常未被考虑。延迟干预与不良患者预后相关,这强调了对于出现腹痛的患者,尤其是有长期饮酒史的患者,需要考虑胆囊损伤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/79b6/10516145/3c04943abbe6/cureus-0015-00000043982-i01.jpg

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