Isolated gallbladder injury following blunt abdominal trauma: A rare surgical presentation

Title : Isolated gallbladder injury following blunt abdominal trauma: A rare surgical presentation

Abstract:

Background: Isolated gallbladder injury following blunt abdominal trauma is an uncommon and diagnostically challenging condition. Its clinical presentation is frequently nonspecific, mimicking other intra-abdominal pathologies, and necessitates a high index of clinical suspicion, appropriate imaging, and timely surgical input to prevent life-threatening complications.

Case Presentation: We present a case of isolated gallbladder perforation in a male in his late 40s who presented to the Emergency Department following blunt abdominal trauma sustained during a physical assault. On examination, he was haemodynamically stable with right upper quadrant abdominal tenderness. Initial investigations included laboratory blood tests and contrast-enhanced computed tomography (CT) of the abdomen and pelvis, which demonstrated free fluid and pericholecystic inflammatory changes consistent with gallbladder injury. No other intra-abdominal injuries were identified on imaging. The patient underwent emergency diagnostic laparoscopy and laparoscopic cholecystectomy within 14 hours of initial presentation. Intraoperative findings confirmed an isolated full-thickness gallbladder perforation at the level of Hartmann's pouch, with no associated injury to surrounding viscera or vascular structures. He made an uneventful postoperative recovery. 

Conclusion: Isolated gallbladder injury secondary to blunt trauma is rare, and diagnosis requires clinical vigilance combined with cross-sectional imaging. Early surgical intervention, including laparoscopic cholecystectomy, is both safe and effective. This case contributes to the limited published literature on this injury pattern and highlights the importance of maintaining a broad differential diagnosis in patients presenting with abdominal pain following blunt trauma.

Keywords: isolated gallbladder injury; blunt abdominal trauma; laparoscopic cholecystectomy; gallbladder perforation; emergency surgery

Biography:

Afua T. Agyei, BSc. Human Biology, MbChB, MPH, MRCGP, MRCS
Afua T. Agyei is a core surgical Trainee in the Kent, Surrey and Sussex Deanery. She completed her primary medical education at the Kwame Nkrumah University of Science and Technology, Ghana. After completing her foundation year training in 37 Military Hospital and Greater Accra Regional Hospitals, she pursued a Masters in Public Health. She holds memberships of the Royal College of General Practitioners and Royal College of Surgeons and is passionate about pursuing a career in colorectal surgery, clinical research and teaching.