TRAUMATIC AVULSION OF THE GALLBLADDER AGGRAVATED BY MINOR TRAUMA DURING NON-OPERATIVE MANAGEMENT : A CASE REPORT

Abstract

　　Traumatic avulsion of the gallbladder refers to tearing of the gallbladder from its fossa in the hepatic bed. It is often surgically treated ; however, there have been reports of non-operative management. We present a case of avulsion that was treated conservatively, which worsened after a fall and required emergency surgery. A 42-year-old man with alcoholic liver cirrhosis fell down the stairs and was consequently admitted to our hospital. He was diagnosed with traumatic gallbladder injury (avulsion and contusion) and conservatively treated. His condition was stable, but on the 11th day of hospitalization, he experienced shock due to a fall. A ruptured gallbladder was diagnosed, and he underwent emergency laparotomy. The area of gallbladder that had detached from the liver bed was heavily perforated. It is important to keep in mind that patients who are getting better must be monitored closely, as even minor trauma may aggravate avulsion.