腹部钝性创伤后胆囊破裂致死性事件1例

Roya Kordrostami, M. Ameri, Nahid Dadashzade, T. Ramim
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摘要

胆囊外伤性损伤因其所处的解剖位置而罕见发生,约占创伤病例的2% ~ 5%。钝性腹部创伤中孤立性胆囊破裂的诊断通常是延迟的,大部分是在手术中发现的。在诊断胆囊损伤时,应考虑钝性腹部外伤中胆囊等脏器损伤的可能性,并采用详细的诊断方法。一名85岁女性因面部和腹部创伤被转介到医院。右上象限(RUQ)区有轻度压痛。超声集中检查胆囊积液。患者在48小时后接受腹部超声检查,报告肝脏广泛破裂和包膜下血肿。患者在48小时后接受腹部超声检查,报告肝脏广泛破裂和包膜下血肿。第二天,患者出现严重的心动过缓,最终因心脏骤停和心脏停止而死亡。尸检发现,胆囊破裂导致绿色化脓性胆汁在腹部流出。本文报告一例钝性腹部创伤后孤立性胆囊损伤,在创伤后评估中未被诊断,并在患者死亡后尸检中发现。诊断胆囊损伤的最佳方法是腹部计算机断层扫描。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Fatal Event of the Gallbladder Rupture Following the Blunt Abdominal Trauma: A Case Report
The gallbladder traumatic injury rarely happens due to its anatomical location and includes 2%-5% of trauma cases. The diagnoses of isolated gallbladder rupture in the blunt abdominal trauma are usually delayed and mostly revealed during the surgeries. To diagnose gallbladder injuries, the probability of injury in an organ such as gallbladder in the blunt abdominal trauma should be considered and accordingly the detailed diagnostic method should be used. A 85-year-old female was referred to the hospital due to facial and abdominal trauma. There was a mild tenderness in the right upper quadrant (RUQ) area. The hydrops gallbladder was observed in the focused assessment with sonography. The patient was assessed by abdominal ultrasonography after 48 hours and reports liver extensive rupture and sub-capsular hematoma. The patient was assessed by abdominal ultrasonography after 48 hours and reports liver extensive rupture and sub-capsular hematoma. The following day, the patient had severe bradycardia and finally dead due to asystole and cardiac arrest. In autopsy, the gallbladder rupture caused the green purulent bile discharge released over the abdomen. The current paper reports a case on isolated gallbladder injury following the blunt abdominal trauma which was not diagnosed in post-traumatic evaluations and was revealed by autopsy after patient’s death. The best method to diagnose gallbladder injuries is the computed tomography (CT) of the abdomen.
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