Traumatic gallbladder rupture in a 9-year-old child

We present gallbladder rupture following trauma. A 9-year-old boy admitted in 1.5 hours after injury. Considering clinical and ultrasound data, we diagnosed traumatic damage to the spleen and hemoperitoneum, biliary dyskinesia, cholestasis, sludge. Hemostatic therapy was carried out. After 3 days, s...

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Bibliographic Details
Published in:	Hirurgija (Moskva) no. 8; p. 96
Main Authors:	Shangareeva, R Kh, Chendulaeva, I G, Kovaleva, V D, Salimgareev, A A
Format:	Journal Article
Language:	Russian
Published:	Russia (Federation) 2024
Subjects:	Abdominal Injuries - complications Abdominal Injuries - diagnosis Abdominal Injuries - surgery Child Cholecystectomy - methods Gallbladder - injuries Gallbladder - surgery Humans Male Multiple Trauma - diagnosis Multiple Trauma - surgery Peritonitis - diagnosis Peritonitis - etiology Peritonitis - surgery Rupture Spleen - injuries Treatment Outcome Ultrasonography - methods Wounds, Nonpenetrating - complications Wounds, Nonpenetrating - diagnosis children traumatic gallbladder rupture biliary peritonitis combined trauma
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Summary:	We present gallbladder rupture following trauma. A 9-year-old boy admitted in 1.5 hours after injury. Considering clinical and ultrasound data, we diagnosed traumatic damage to the spleen and hemoperitoneum, biliary dyskinesia, cholestasis, sludge. Hemostatic therapy was carried out. After 3 days, signs of peritonitis appeared. Follow-up ultrasound revealed gallbladder enlargement with heterogeneous content, fluid in all parts of abdominal cavity. Intraoperatively, the gallbladder was enveloped in omentum soaked in bile. After mobilization of the gallbladder, we found longitudinal linear tear up to 3 cm clogged with omentum. Cholecystectomy was performed. Thus, we present a patient with combined injury and damage to the spleen. However, gallbladder wall thickening and heterogeneous content were interpreted as concomitant pathology. Delayed manifestation of peritonitis was due to gallbladder enveloped in omentum. The last one soaked in bile partially entered the gallbladder through perforation and prevented bile leakage into abdominal cavity. Timely diagnosis of gallbladder damage presents certain difficulties, especially in case of combined injury. Ultrasound signs of traumatic gallbladder rupture in this case were wall thickening, heterogeneous content and gradual gallbladder enlargement. It is necessary to analyze all organs at the damage site including computed tomography in patients with combined trauma.
ISSN:	0023-1207
DOI:	10.17116/hirurgia202408196