Blunt gallbladder injuries: presentation of twenty-two cases with review of the literature.

Blunt injuries to the gallbladder are very uncommon, whereas penetrating gallbladder trauma occurs more frequently. Over the last 19-year period through 1994, 22 cases with blunt gallbladder trauma were treated. Avulsion (partial or complete) and contusion were observed in 10 cases each (45%). Perforation of the gallbladder and traumatic cholecystitis with necrosis were seen in one case each. Associated intra-abdominal trauma was present in 100% of the cases and accounted for both mortalities. Gallbladder injury was diagnosed after celiotomy, except for one case that was diagnosed and treated nonoperatively. Based on the experiences gained herein and an extensive review of the literature, a classification scheme for gallbladder trauma and its treatment is presented.