journal article Aug 15, 2021

Isolated gallbladder perforation in paediatric blunt abdominal injury: A case report and review of literature

View at Publisher Save 10.18231/j.ijmpo.2021.020
Abstract
Gallbladder injury in blunt abdominal trauma is rare, around 2% of all abdominal traumas. Vague symptoms and inconclusive imaging make it an elusive diagnosis, more so in children. Only 30 pediatric cases have been reported worldwide till date. We report a case of a 7yrs old boy presenting 2 weeks after a road accident with a gallbladder rupture which was eventually discovered on a diagnostic laparoscopy. This is the second such case being reported from India. The injury is most often identified at exploration and although cholecystectomy is the preferred treatment, there are occasions when the gallbladder may be left in situ. The classification system of Losanoff and Kjossev has merit in guiding treatment. The various presentations, mechanisms and modes of injury have been highlighted along with the clinical and imaging findings. Despite the developments in modern radiology, identifying gallbladder perforation has always been difficult because of the rarity of the condition. In a child with blunt abdominal trauma and intra-abdominal free fluid without any solid organ injury, a diagnostic peritoneal tap may be helpful. Based on the current evidence, we advocate a low threshold for performing a diagnostic laparoscopy in all such cases.
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References
34
[4]
Wiener I, Watson L C, Wolma F J, Perforation of the gallbladder due to blunt abdominal trauma.Arch Surg 1982;117:805-7 10.1001/archsurg.1982.01380300047011
[5]
Sharma O, Blunt gallbladder injuries: presentation of twenty-two cases with review of the literature.J Trauma Acute Care Surg 1995;39(3):576-80 10.1097/00005373-199509000-00029
[7]
Ricketts BM, Rupture of the gallbladder (spontaneous and traumatic, with and without operation) an historical review of 273 cases.St Louis Med Rev.108-21
[8]
Lewerenz I S, Yber die subcutanen rupturen der gallenwege traumatischen ursprungs nebst einem casuistischen beitrag.Arch f Klin Chir Berl 1903;71:111-46
[9]
Balmiki P, Ionare R, Apte A, Sr N Tyagi , Isolated gallbladder perforation after trivial abdominal trauma in a child : a case report and review of the literature.IOSR J Dent Med Sci 2014;13(9):44-51 10.9790/0853-13974447
[10]
Niemeier O, Acute free perforation of the gall-bladder.Ann Surg 1934;99(6):922-44 10.1097/00000658-193406000-00005
[13]
Schechter D, Solitary wounding of gallbladder from the blunt abdominal trauma.NY State J Med.2895-901
[17]
MA Wittenberg A, CT diagnosis of traumatic gallbladder injury.Am J Roentgenol 2005;185(6):1573-4 10.2214/ajr.04.1637
[18]
Robertson H, The injured abdomen: a consideration of visceral injuries due to trauma where the abdominal wall has not been perforated.Am J Surg 1931;14(2):395-418 10.1016/s0002-9610(31)91169-0
[19]
Norgore M, Traumatic rupture of the gallbladder: case reports and notes on choleperitoneum.Ann Surg 1946;123(1):127-34 10.1097/00000658-194601000-00012
[20]
Behdad A, Torsion and gangrene of the gallbladder in a child.Med J Islam Repub Iran 1998;12(2):191-2
[21]
Birn J, Jung M, Dearing M, Isolated gallbladder injury in a case of blunt abdominal trauma.J Radiol Case Rep 2012;6(4):25-30 10.3941/jrcr.v6i4.941
[24]
Sengstaken R, Traumatic rupture of the gallbladder.Ann Surg 1944;119:959 10.1097/00000658-194406000-00017
[29]
Grimes O, Steinbach H, Traumatic cholecystocutaneous fistula.AMA Arch Surg 1955;71(1):68-70 10.1001/archsurg.1955.01270130070010
[30]
Fawaz F, Kim S, A case of traumatic cholecystitis.W V Med J 1985;81(2):32
[31]
Fortier L, Subcutaneous traumatic rupture of the gallbladder.New Orleans Med Surg J 1915;67:448-9
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Details
Published
Aug 15, 2021
Vol/Issue
7(2)
Pages
103-107
Cite This Article
Sujoy Neogi, Arka Banerjee, Shasanka S Panda, et al. (2021). Isolated gallbladder perforation in paediatric blunt abdominal injury: A case report and review of literature. IP International Journal of Medical Paediatrics and Oncology, 7(2), 103-107. https://doi.org/10.18231/j.ijmpo.2021.020