2019 Volume 39 Issue 5 Pages 939-943
A 45–year–old man was taken to the ER because his car had collided head–on with a guardrail. On examination, we observed upper abdominal tenderness, slight anemia, and increased hepatobiliary enzyme levels. Abdominal US showed an echo–free space under the liver. Contrast enhanced abdominal CT showed extravasation on the gallbladder bed. From these findings, we made the diagnosis of traumatic liver injury along the Cantlie’s line with hemorrhagic shock and performed an emergency laparotomy. We blocked the blood supply to the liver by the Pringle maneuver and found an enlarged gallbladder, which was avulsed from the gallbladder bed. It was linked to the hepatoduodenal ligament only via the cystic duct and cystic artery. We could stop the bleeding by performing a cholecystectomy. Gallbladder avulsion caused by blunt abdominal trauma can be an important morphology of injury because it should be distinguished from liver injury when deciding on the therapeutic strategy.
