Traumatic rupture of the gallbladder
Punched in the abdomen. Now has severe right upper quadrant pain with generalized peritonitis
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Large volume free fluid throughout the peritoneal cavity with a HU density of 4-6. Contracted gall bladder with a defect in its wall (arrow) surrounded by this fluid including in the gall bladder fossa together with minor contusion to the adjacent liver (arrow).
The gallbladder is relatively protected from injury, but can be injured (ruptured) with direct anterior abdominal wall impact as in this case with a punch. There is usually associated liver injury as in this case. Confirmation of the diagnosis requires paracentesis with the finding of bile in the drained fluid.