Blunt Abdominal Injury With Isolated Gallbladder Hematoma
Received 11 December 2008; received in revised form 5 January 2009; accepted 23 January 2009.
Abstract
Blunt abdominal contusion is common in children, but isolated injury with gallbladder hematoma is rarely observed. Examining children can be difficult because they may not cooperate or understand procedures, and therefore, radiography is helpful for diagnosis. However, there are still limitations in applying radiographic examinations in diagnosing intra-abdominal injuries, especially in children with peritoneal signs or an unstable hemodynamic status. In these circumstances, invasive intervention with laparoscopy should be applied for further evaluation. We report here a 6-year-old girl with blunt abdominal trauma in whom hepatobiliary injury was noted on computed tomography and magnetic resonance imaging. Because the patient was unconscious, had unstable vital signs, and the radiographic study was ambiguous, peritonitis could not be excluded. A laparoscopy was then performed and isolated gallbladder hematoma was diagnosed. The patient was discharged after laparoscopic intervention and orthopedic fixation.
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aDivision of Trauma Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
bDepartment of Emergency Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
cGraduate Institute of Healthcare Administration, Kaohsiung Medical University, Kaohsiung, Taiwan
dDivision of Infectious Diseases, Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan
Corresponding author. Division of Trauma Surgery, Department of Surgery, Kaohsiung Medical University Hospital, 100, Tzyou 1st Road, Kaohsiung, Taiwan