Delayed Perforation of the Gallbladder after Blunt Abdominal Trauma

Isolated injury of the gallbladder rarely occurs after blunt abdominal trauma and, if so, is usually associated with damage to other intra-abdominal organs clearly necessitating surgical intervention. Blunt abdominal trauma is often overlooked because there may be no visible signs on the abdominal wall. It is important to closely follow patients and look for early signs of organ damage, as isolated injury of the gallbladder often follows a vague and insidious clinical course. A combination of special investigations may be required to confirm the diagnosis of this relatively rare but serious injury. Our case was a 38-year-old female, admitted to the hospital with a history of blunt abdominal trauma secondary to a fall. Initial computed tomographic scan demonstrated an edematous gallbladder; a follow-up computed tomographic scan showed a 5-cm collection of fluid around the gallbladder, suspicious for gallbladder perforation. Diagnostic laparoscopy followed by laparoscopic cholecystectomy was performed without complications. The postoperative course was uneventful and the patient was discharged on postoperative day three. (J Korean Surg Soc 2006;70: 411-413)