1/22. gallbladder injury in blunt abdominal trauma.A 36-year-old woman was admitted to the hospital for an abdominal blunt trauma. At ultrasound (US) and computed tomography (CT), a gallbladder lesion was suspected, along with a tear of the liver. The patient was submitted to a diagnostic laparoscopy. The gallbladder was partially avulsed and bile was infiltrated in the hepatoduodenal ligament. Intraoperative cholangiography and Kocher's maneuver excluded other lesions. Laparoscopic cholecystectomy was performed, but due to severe hemorrhage from the liver tear, the operation was converted to an open procedure. gallbladder lesions in blunt trauma are rare occurrences, but they are often associated with other organ injuries. US and CT scan are valuable for their diagnosis, but if a lesion is suspected, diagnostic laparoscopy is advisable in stable patients. It should be accompanied by a cystic duct cholangiography and a Kocher's maneuver to evaluate the integrity of the biliary tree. Laparoscopic cholecystectomy is generally feasible. Associated lesions require laparotomy when they are not amenable to laparoscopic treatment.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
2/22. laparoscopy in a case of pediatric blunt abdominal trauma.The use of laparoscopy in the assessment and treatment of blunt abdominal trauma has been reported for both adults and children. With increasing surgical experience and improvements in equipment, an expanding range of therapeutic interventions is available. The management of a 7-year-old boy who sustained blunt abdominal trauma during a fall from a bicycle is described. He was hemodynamically stable, but his abdomen remained tender, with guarding in the right upper quadrant. Serial ultrasound scans showed a thick-walled gallbladder and increasing intraabdominal fluid. laparoscopy was used both as a diagnostic tool, and then as a therapeutic method. Diagnostic laparoscopy showed a ruptured gallbladder treated by laparoscopic cholecystectomy. A 3-cm grade 1 liver laceration also was identified, which required no intervention. Free bile was aspirated and the peritoneal cavity thoroughly lavaged. The child made a rapid postoperative recovery. The ultimate aim in the management of blunt trauma is to avoid unnecessary laparotomy while preventing undue delay in the detection of significant intraabdominal pathology. Computed tomography scanning, ultrasound scanning, and diagnostic peritoneal lavage all have strengths for detecting different injury types, but they also have a low specificity in determining the need for laparotomy. The advantages and limitations of laparoscopy in hemodynamically stable children who have sustained injuries from blunt trauma are discussed. The authors recommend laparoscopy in experienced hands as an additional tool for the optimal management of selected trauma cases.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
3/22. Laparoscopic treatment of an isolated gallbladder rupture following blunt abdominal trauma in a schoolboy rugby player.Laparoscopic treatment of an isolated gallbladder rupture in a schoolboy rugby player resulting from blunt abdominal trauma has not previously been reported. A case report of this rare occurrence is presented together with a brief review of the literature.- - - - - - - - - - ranking = 2.5keywords = gallbladder (Clic here for more details about this article) |
4/22. Sonographic diagnosis of traumatic gallbladder rupture.gallbladder injuries after blunt abdominal trauma are rare and often follow a vague and insidious clinical course. Consequently, gallbladder injuries commonly go undiagnosed until exploratory laparotomy. early diagnosis is essential, because trauma to the gallbladder is typically treated surgically, and delay in treatment can result in considerable mortality and morbidity. With sonography emerging as a first-line modality for evaluation of intra-abdominal trauma, sonographers may wish to become more familiar with the appearance of gallbladder injury on sonography to facilitate earlier diagnosis and to improve treatment and prognosis. We report a case of gallbladder perforation after blunt abdominal trauma diagnosed on the basis of computed tomography (CT) and sonography.- - - - - - - - - - ranking = 4keywords = gallbladder (Clic here for more details about this article) |
5/22. gallbladder injuries due to blunt abdominal trauma: report on five cases and review of the literature.gallbladder lesions by blunt abdominal trauma are rare, due to the organ's anatomical particularities. Diagnosis is difficult, and it generally occurs during surgery. The trauma is usually associated with other lesions and is related to very serious traumas or to deceleration. Due to the scarcity of publications on this topic and to its reduced incidence, we present here a report of five patients who had suffered blunt abdominal trauma with gallbladder lesion and who were attended at the General Hospital (of the University of Sao Paulo Medical School) Emergency Service between 1986 and 1991. Furthermore, we analyze the incidence of this trauma, presence of associated lesion, treatment, morbidity and mortality of the patients, as well as a review of the literature.- - - - - - - - - - ranking = 0.5keywords = gallbladder (Clic here for more details about this article) |
6/22. Traumatic cholecystectomy.Avulsion of the gallbladder from its liver bed with detachment from both cystic duct and artery is an exceedingly rare consequence of blunt abdominal injury. A case is reported in which early recognition by diagnostic peritoneal lavage led to successful treatment.- - - - - - - - - - ranking = 0.5keywords = gallbladder (Clic here for more details about this article) |
7/22. Avulsion of the gallbladder following trivial injury.Traumatic cholecystectomy is a rare condition that has always been described in the context of major trauma and associated liver or biliary injuries. We present a case of isolated traumatic cholecystectomy following a trivial injury which resulted in both a delayed presentation and a difficult diagnosis.- - - - - - - - - - ranking = 2keywords = gallbladder (Clic here for more details about this article) |
8/22. Mesh wrap in severe pediatric liver trauma.PURPOSE: This study reviews the authors' experience in treating severe pediatric liver injuries with absorbable mesh wrapping. The authors found this relatively new therapeutic method very useful in selected cases, although its use is not very common in children. The authors analyze the indication describe some technical aspects, and discuss the advantages and the pitfalls of the method. methods: In a 10-year period between 1990 and 2000, 181 children were admitted to Hillel-Yaffe Medical Center with blunt hepatic trauma. A total of 132 children were treated conservatively, and 49 (27%) were operated on. The operated group included 35 cases of isolated liver injuries and 14 cases of additional intraabdominal injuries. Thirty-four children were operated on between 1990 and 1995 (36% of 96 children), whereas between 1995 and 2000, 15 children were operated on (17% of 85 children), including 4 children aged 18 months to 15 years with massive liver bleeding who were treated with mesh wrap technique. The retrospective analysis of these 4 cases indicates a progressive policy in the recognition of cases suitable for mesh wrapping and gallbladder conservation. RESULTS: The perihepatic mesh wrap technique controlled the bleeding in all children. In 3 of them the right lobe was wrapped, and, in 1 case, total liver wrapping was performed. Hepatic enzymes and bilirubin levels were elevated in the first 3 to 7 days and declined gradually to normal levels. The perihepatic mesh was not an obstacle to a transcutaneous drainage of an intrahepatic biloma. All 4 children returned to normal physical activities. CONCLUSIONS: Liver mesh wrap is a simple, effective, and rapid way to obtain hemostasis and to conserve parenchyma in severe traumatized liver. The decision to wrap the liver should be done early to prevent acidosis and hypothermia. cholecystectomy is not an integral part of the procedure in children. The morbidity is low, and most of the complications can be treated nonsurgically.- - - - - - - - - - ranking = 0.5keywords = gallbladder (Clic here for more details about this article) |
9/22. Fatal hemoperitoneum from traumatic gallbladder avulsion: an autopsy case report.This report describes a rare autopsy case of death due to gallbladder injury. The victim was a 63-year-old man, with a clinical history of liver cirrhosis and alcohol abuse. The postmortem examination revealed fatal hemoperitoneum from traumatic gallbladder avulsion. Related injuries were observed in the right hypochondriac region. Normal distended gallbladder, liver cirrhosis and alcohol abuse were considered to be the predisposing factors. The gradual development of bleeding from the small vessels of the gallbladder and the liver bed may have caused extensive hemoperitoneum.- - - - - - - - - - ranking = 4keywords = gallbladder (Clic here for more details about this article) |
10/22. Isolated chyle duct injury in blunt trauma.We present a case of a patient sustaining an isolated injury to the right main branch of the cysterna chyli due to a high-speed motor vehicle accident. A 42-year-old man presented after a high-speed collision. CT revealed a collection of hypodense fluid in the gallbladder fossa, which was the clue to take him to the OR. We proceeded to laparoscopic exploration, and based on the milky white color of the fluid, identified a chyle leak. In an open fashion, the retroperitoneum was explored and the injury was identified as disruption of the right lumbar branch entering the cisterna chyli, and this was ligated with silk ties. chyle duct injury secondary to blunt trauma is a rare finding. The use of CT imaging can identify this injury. laparoscopy can confirm the injury. Open ligation of the injured duct is the best treatment.- - - - - - - - - - ranking = 0.5keywords = gallbladder (Clic here for more details about this article) |
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