A Case Report of the Traumatic Rupture of the Gallbladder

Hiroyuki Yasuda, Atsuyoshi Onitsuka, Tomoyuki Miyata

Department of Surgery, Kaizu Medical Association Hospital

A 49-year-old man sustained an injury in a car accident while under the influence of alcohol. The patient was clinically stable and was observed under conservative management. On the sixth days after the trauma, total bilirubin increased to 5.0 mg/dl. Computed tomography enhanced with Biligraphin (DIC-CT) revealed extrabiliary accumulation of contrast medium, indicating injury of the extrahepatic biliary system. ERC revealed extrabiliary opacification from the gallbladder. Laparotomy 16 days after the trauma showed bile-like ascites in the peritoneal cavity. The gallbladder was dissected traumatically from its bed and a performation was seen on the body of the gallbladder. There were no other injuries, and cholecystectomy with abdominal drainage was performed. The sresected specimen showed no hematoma in the wall of the gallbladder. It is considered worthwhile to perform DIC-CT to diagnose biliary injury in patients withabdominal trauma.

Key words
rupture of the gallbladder, blunt abdomrinal trauma

Reprint requests
Hiroyuki Yasuda Department of Surgery, Gifu University School of Medicine
40 Tsukasa-machi, Gifu-City, 500 JAPAN

Accepted
September 14, 1994

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