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Delayed Rupture of Gallbladder Following Blunt Abdominal Trauma

机译:钝性腹部创伤后胆囊破裂延迟

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摘要

A 29-year-old gentleman presented to surgery emergency with severe upper abdominal pain and vomiting. He reported to had been hit in his abdomen by a ball during a cricket match. Computerized tomogram of the abdomen revealed hematoma within the gallbladder lumen, laceration of segment six of liver, and hemoperitoneum. The patient did not agree for laparotomy advised to him, and so, managed conservatively. The patient reported back to us with high grade fever, jaundice, and painful abdominal distension after seven days of discharge from the hospital. His abdominal examination showed features of generalized peritonitis. Surgical abdominal exploration revealed a single perforation in the fundus of gallbladder with frozen calot'striangle. Subtotal cholecystectomy was done. Histopathology of excised gallbladder revealed xanthogranulomatous inflammation. The present case report highlights that early exploration and cholecystectomy should be considered in patients with gallbladder injury to obviate the risk of delayed perforation.
机译:一位29岁的绅士因上腹部剧烈疼痛和呕吐而急诊手术。据报道,他在板球比赛中被一个球击中腹部。腹部计算机断层扫描显示胆囊腔内有血肿,肝脏第6段撕裂和腹膜出血。患者不同意建议他进行剖腹手术,因此采取了保守治疗。出院七天后,患者向我们报告了高烧,黄疸和腹痛。他的腹部检查显示出全身性腹膜炎的特征。腹部手术探查发现胆囊底部结扎了单个穿孔,并伴有冰冻的小腿三角形。进行了部分次胆囊切除术。切除的胆囊的组织病理学表现为黄皮肉芽肿性炎症。本病例报告强调,胆囊损伤患者应考虑早期探查和胆囊切除术,以消除穿孔延迟的风险。

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