Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 6, 2021; 9(28): 8518-8523
Published online Oct 6, 2021. doi: 10.12998/wjcc.v9.i28.8518
Spontaneous resolution of gallbladder hematoma in blunt traumatic injury: A case report
Hyunseok Jang, Chang-Hwan Park, Yunchul Park, Euisung Jeong, Naa Lee, Jungchul Kim, Younggoun Jo
Hyunseok Jang, Yunchul Park, Euisung Jeong, Naa Lee, Jungchul Kim, Younggoun Jo, Division of Trauma, Department of Surgery, Chonnam National University Medical School and Hospital, Dong-gu 61469, Gwangju, South Korea
Chang-Hwan Park, Department of Internal Medicine, Chonnam National University Medical School and Hospital, Dong-gu 61469, Gwangju, South Korea
Author contributions: Jang H and Jo Y wrote the manuscript and Jeong E obtained the figures; Park CH and Park Y were the patient’s physicians; Lee N contributed to the discussion and interpretation of this manuscript; Kim J made the critical revision; all authors have read and approved the final version of the manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: None of the authors had conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Younggoun Jo, MD, Assistant Professor, Division of Trauma, Department of Surgery, Chonnam National University Medical School and Hospital, 42 Jebong-ro, Dong-gu 61469, Gwangju, South Korea.
Received: April 6, 2021
Peer-review started: April 6, 2021
First decision: April 28, 2021
Revised: May 12, 2021
Accepted: August 5, 2021
Article in press: August 5, 2021
Published online: October 6, 2021

We report a case of intragallbladder hematoma and biliary tract obstruction caused by blunt gallbladder injury. We report that the patient was safely treated by conservative treatment after the obstruction was resolved by endoscopic retrograde cholangiopancreatography (ERCP).


A 67-year-old man was admitted via the emergency department due to complaints of right-sided abdominal pain that started 2 d prior. Four days prior to presentation, the patient had slipped, fallen and struck his abdomen on a motorcycle handle. His initial vital signs were stable. On physical examination, he showed right upper quadrant pain and Murphy’s sign, with decreased bowel sounds. Additionally, he had had a poor appetite for 4 d. He had been on aspirin for 2 years due to underlying hypertension. Initial simple radiography revealed a slight ileus. The laboratory findings were as follows: white blood cell count, 15.5 × 103/µL (normal range 4.8 × 103–10.8 × 103); hemoglobin, 9.4 g/dL; aspartate aminotransferase/alanine transferase, 423/348 U/L; total bilirubin/direct bilirubin, 4.45/3.26 mg/dL; -GTP , 639 U/L (normal range 5–61 U/L); and C-reactive protein, 12.32 mg/dL (0–0.3). Abdominal computed tomography showed a distended gallbladder with edematous wall change and a 55 mm × 40 mm hematoma. Dilatation was observed in both the intrahepatic and common bile duct areas. Antibiotic treatment was initiated, and ERCP was performed, with hemobilia found during treatment. After cannulation, the patient’s symptoms were relieved, and after conservative management, the patient was discharged with no further complications. After 1-month follow-up, the gallbladder hematoma was completely resolved.


In the case of traumatic injury to the gallbladder, conservative treatment is feasible even in the presence of hematoma.

Keywords: Gallbladder, Trauma, Abdomnial injuries, Blunt injuries, Cholecystitis, Gallstone, Case report

Core tip: Intragallbladder hematoma is a rare event in trauma. Most of the hematomas in the gallbladder and blunt traumatic injury of the gallbladder itself can lead to complications such as delayed perforation, gallstone formation due to clot retention, and hemorrhagic cholecystitis. In most cases, these gallbladder hematomas require cholecystectomy or external drainage. However, such as in our case, after endoscopic retrograde cholangiopancreatography was performed and retention of the tract was resolved, conservative treatment should be considered as a treatment option if the laboratory test results show improvement, and the patient shows a favorable clinical course.