7 Delayed detection of trauma to the extrahepatic biliary system is associated with high morbidity. 6 A delay in diagnosis of isolated gallbladder ruptures is not uncommon as initial symptoms are often vague, before a period of clinical deterioration resulting from bile peritonitis. Gallbladder rupture is most commonly due to penetrating trauma and there are seldom published reports that attribute an isolated gallbladder rupture to BAT. Subsequently, the mortality associated with gallbladder injuries is reflective of the mortality resulting from concomitant injuries. 3 4 It is these associated injuries that most frequently determine patient management and prognosis. However, if this protective position is breached due to blunt force and produces a gallbladder injury, other serious intra-abdominal injuries are almost always present (>98% incidence of concomitant intra-abdominal pathology is described in the literature, commonly a liver or major intra-abdominal blood vessel injury). Its protective anatomical location likely accounts for the considerably low incidence of traumatic gallbladder injuries following blunt abdominal trauma (BAT). 1 2 It is located within the gallbladder fossa on the visceral surface of the right lobe of the liver, sheltered by the right costal margin, the liver and adjacent alimentary tract. The gallbladder is a pear-shaped, fibromuscular sac.
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