Gallbladder injury secondary to blunt trauma: CT findings

Our objective was to determine CT findings of gallbladder injury secondary to blunt trauma.

Computed tomography scans and medical records of seven patients diagnosed with gallbladder injury secondary to blunt trauma, including six surgically confirmed cases and one presumptive diagnosis based on CT findings, were reviewed retrospectively to delineate CT findings associated with gallbladder injury. Evaluation of CT scans included assessment of gallbladder distention, wall thickness and contour, intraluminal contents, presence of pericholecystic fluid, and associated injuries. Data obtained included age, gender, mechanism of injury, surgical and pathologic findings when available, treatment, morbidity, and mortality.

Four patients had gallbladder contusions and three had either gallbladder laceration, partial avulsion, or intraluminal hemorrhage. The spectrum of CT findings included pericholecystic fluid (seven), ill defined contour of the gallbladder wall (four), high density intraluminal hemorrhage (four), mass effect on the duodenum (three), and gallbladder collapse (one). No combination of findings was specific for the type of injury. The most common associated injuries were pericholecystic liver lacerations and duodenal hematoma or perforation.

The CT finding of an ill defined contour of the gallbladder wall, a collapsed lumen, or high density intraluminal hemorrhage, especially in the presence of pericholecystic fluid, strongly suggests primary gallbladder injury.