Traumatic rupture of the gallbladder with massive biliary ascites

TRAUMATIC laceration of the gallbladder with subsequent bile leakage into the peritoneum (choleperitoneum) is a rare complication of blunt abdominal trauma. Fewer than 50 cases have been reported in the English literature. Most cases have involved either children or adolescents, as the incidence of accidents in this group is the highest. The occasional cases reported in adults are usually secondary to steering wheel or seat belt injuries. If no other visceral organ is damaged and there are no signs of shock or hemoperitoneum, the delay in diagnosis can be as long as six weeks. In the rare instance when the patient has known chronic liver disease and ascites, the diagnosis may be further delayed. We present a case in which the diagnosis was established seven weeks after admission with the aid of a "skinny-needle" percutaneous transhepatic cholangiogram (PTC). Report of a Case A 53-year-old man was admitted to the hospital