Year 2015 / Volume 107 / Number 12
Letter to the Editor
Giant biloma as a result of a blunt abdominal trauma: A case report

768-769

DOI: 10.17235/reed.2015.3886/2015

José Alberto Ferrusquía Acosta, Carmen Álvarez Navascués, Manuel Rodríguez García,

Abstract
A 58-year-old man with a history of a heavy alcohol intake was admitted to hospital for a 3-weeks history of abdominal discomfort, nausea, vomiting and an increased abdominal girth that appeared progressively after an abdominal trauma due to an accidental fall. On physical examination, jaundice was present and the abdomen was distended with no tenderness on palpation. Laboratory studies showed an increased white-cell count, an elevated C-reactive protein and abnormal liver-function tests. Abdominal ultrasonography showed a large fluid collection in the right side of the abdomen. An abdominal computed tomography scan revealed a gallbladder perforation communicating to a big subcapsular hepatic biloma of 9.5 by 25.0 by 35.0 centimeters, which was compressing the liver and other intraabdominal organs. Finally, our patient underwent an open cholecystectomy with drainage of the biloma, and a partial resection of the Glisson’s capsule. Macroscopic and microscopic examination of the resected specimens confirmed the diagnosis of traumatic gallbladder perforation. Gallbladder traumatic injury is a rare entity. The diagnosis represents a challenge because of its low incidence, its association with other lesions of vital organs and the nonspecific and insidious symptoms that can produce. Treatment depends on the type and severity of the damage caused; nevertheless, cholecystectomy remains the treatment of choice in patients with rupture or avulsion of the gallbladder. To our knowledge, this is the first report in the English literature of an isolated blunt traumatic gallbladder injury that was associated with the development of a large biloma.
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References
1. Jaggard MK, Johal NS, Choudhry M. Blunt abdominal trauma resulting in gallbladder injury: a review with emphasis on pediatrics. J Trauma. 2011; 70: 1005-10
2. Pavlidis TE, Lalountas MA, Psarras K, et al. Isolated complete avulsion of the gallbladder (near traumatic cholecystectomy): A case report and review of the literature. J Med Case Rep. 2011; 5: 392
3. Liess BD, Awad ZT, Eubanks WS. Laparoscopic cholecystectomy for isolated traumatic rupture of the gallbladder following blunt abdominal injury. J Laparoendosc Adv Surg Tech A. 2006; 16: 623-5
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Ferrusquía Acosta J, Álvarez Navascués C, Rodríguez García M. Giant biloma as a result of a blunt abdominal trauma: A case report. 3886/2015


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Publication history

Received: 09/06/2015

Accepted: 22/06/2015

Online First: 23/11/2015

Published: 03/12/2015

Article revision time: 5 days

Article Online First time: 167 days

Article editing time: 177 days


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