A Case of Blunt Traumatic Intra-gallbladder Bleeding without Rupture

Abstract

A 55-year-old female presented with a 1-day history of abdominal pain, ever since she had been kicked in the abdomen by her husband, and was admitted to the hospital. Contrast-enhanced abdominal CT showed contrast leaking from the wall of the gallbladder into the lumen, and she was diagnosed as having intra-gallbladder bleeding resulting from blunt abdominal trauma. There was no evidence of rupture of the gallbladder or other injuries, therefore, she was managed non-operatively. Delayed cholecystitis occurred on the sixth hospital day and open cholecystectomy was performed. She was discharged six days later after an uneventful postoperative course. Intra-gallbladder bleeding without rupture caused by blunt abdominal trauma is a rare condition ; only a few cases have been reported, most of which were treated surgically. In some recent cases, non-operative therapy has been used, with good outcomes. However, as in the present case, delayed cholecystitis and biliary obstruction due to hematoma may occur. Resection must be considered in the event of delayed cholecystitis complicating the clinical course. Herein we report an extremely rare case of blunt traumatic intra-gallbladder bleeding not associated with rupture of the gallbladder.