腹腔穿刺と腹腔鏡検査が診断に有効であった外傷性胆嚢単独損傷の１例

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  • A case of Solitary Gallbladder Injury due to Trauma Diagnosed with Preoperative Abdominal Paracentesis and Laparoscopy

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Solitary gallbladder injury is uncommon. A 73-year-old man fell down from a roof at work. Since transient quadriplegia appeared, a large quantity of steroids was injected intravenously. As the abdominal pain persisted for five days thereafter, an abdominal CT examination was performed which demonstrated fluid collection in the right subphrenic space. An abdominal paracentesis showed biliary ascites. Prior to surgery, a laparoscopic examination was performed to detect the perforation site as well as to exclude a perforated peptic ulcer. Under the diagnosis of biliary peritonitis, a laparotomy was performed for a close examination of the biliary tract, confirming no other injury, and a cholecystectomy was done. In our solitary gallbladder injury patient, both an abdominal paracentesis and laparoscopic examination were useful for making the diagnosis.

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