1. Trauma to the gallbladder is associated with concurrent injuries to the extra hepatic biliary system: A South African experience.
- Author
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Kong, Victor, Xu, William, Cheung, Cynthia, Rajaretnam, Nigel, Elsabagh, Abdalla, Dholakia, Jhanvi, Bruce, John, Laing, Grant, Manchev, Vassil, and Clarke, Damian
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PENETRATING wounds , *CHOLANGIOGRAPHY , *GALLBLADDER cancer , *GALLBLADDER , *BILIARY tract , *BLUNT trauma , *TRAFFIC accidents , *STAB wounds , *GUNSHOT wounds , *RETROSPECTIVE studies , *ABDOMINAL injuries - Abstract
Introduction: Gallbladder trauma is a rare injury. This study aimed to describe the significance of these injuries and the appropriate management strategies.Methods: A retrospective study was undertaken at a major trauma centre in South Africa and included all patients diagnosed with a gallbladder injury between January 2012 and October 2020.Results: A total of 51 cases were included (88% male, mean age: 38 years), with 44 (86%) penetrating trauma cases [28 stab wounds (SW), 16 sustained gunshot wounds (GSW)]. Of the 7 (13%) blunt trauma cases, five were involved in a motor vehicle crash, and two were injured via assault. All patients underwent laparotomy. Full-thickness gallbladder laceration or perforation was the most common type of injury (84%) and all patients with a gallbladder perforation or laceration had a cholecystectomy at index operation. Two out of 5 patients with a gallbladder contusion were managed conservatively without a cholecystectomy and the remaining three had evidence of gallbladder necrosis which were managed with cholecystectomy. Associated extrahepatic bile duct injuries occurred in 4% of cases, and 18 cases (35%) required intensive care unit (ICU) admission. The overall mortality was 8%.Conclusion: Gallbladder injury is rare but when encountered implies a significant degree of trauma. Although cholecystectomy is usually definitive, there is an association with other occult extra-hepatic biliary tract injuries. The severity of the associated injuries usually determines patient outcomes. [ABSTRACT FROM AUTHOR]- Published
- 2022
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