A 23-year-old man had a serious accident on an electric bicycle that caused his gallbladder to rupture, spilling bile into his abdomen. This is extremely rare—it happens in only about 2 out of every 100 people who have abdominal injuries from blunt trauma. Because the symptoms weren’t obvious at first, doctors almost missed the problem. This case shows why doctors need to think about gallbladder damage when someone has a bad belly injury, especially if they’ve been drinking alcohol, which may make the gallbladder more fragile.

The Quick Take

  • What they studied: A single patient who had a ruptured gallbladder from blunt abdominal trauma and how doctors figured out what was wrong and treated it
  • Who participated: One 23-year-old male patient who was intoxicated when he hit a bollard (post) while riding an electric bicycle and struck his right upper abdomen
  • Key finding: The gallbladder had a 2-centimeter hole that leaked about 300 milliliters of bile into the abdomen, causing a serious infection. Doctors initially thought it might be a liver injury, but special imaging (CT scan) confirmed it was the gallbladder
  • What it means for you: If you have severe belly pain after a blunt injury to your upper right abdomen, especially if you’ve been drinking, make sure doctors consider gallbladder damage. This is rare, but catching it early with proper imaging and surgery can prevent serious complications

The Research Details

This is a case report, which means doctors are describing what happened with one specific patient in detail. The 23-year-old man came to the hospital 11 hours after his bicycle accident complaining of severe belly pain. Doctors first did an ultrasound (sound wave imaging) which showed fluid in his belly and a shrunken gallbladder. When they tested the fluid, they found bile in it, which suggested the gallbladder might be leaking. To confirm the diagnosis and make sure there wasn’t other damage, they performed a CT scan (a detailed X-ray picture) with contrast dye, which clearly showed the gallbladder had a hole in it.

Case reports are important for rare conditions because they help doctors learn about unusual injuries and how to recognize them. Since gallbladder perforation from blunt trauma is so uncommon, sharing detailed information about one case helps other doctors know what to look for and how to diagnose it faster

This is a single case report, so it describes one patient’s experience rather than comparing many patients. While case reports are valuable for rare conditions, they cannot prove that something works for everyone. The strength here is the detailed documentation of the diagnosis process and treatment, which can help other doctors recognize similar cases. The doctors used appropriate imaging tests to confirm their diagnosis before surgery

What the Results Show

The patient arrived at the hospital with severe, widespread belly pain, a fast heart rate (109 beats per minute), and high blood pressure (149/104). Initial ultrasound showed about 58 millimeters of fluid in the abdomen and a gallbladder that appeared shrunken. When doctors tested this fluid with a needle, they found bile in it, which is a strong clue that the gallbladder is leaking. The CT scan with contrast dye confirmed the diagnosis by showing a clear perforation (hole) in the gallbladder. During surgery, doctors found a 2-centimeter hole and about 300 milliliters of bile that had leaked into the belly. After removing the gallbladder (cholecystectomy), the patient received antibiotics and nutritional support and recovered without complications, going home on day 17.

The case highlights how alcohol intoxication may have contributed to the gallbladder’s vulnerability to rupture from the blunt trauma. The delayed presentation (11 hours after injury) made diagnosis more challenging because the symptoms were not specific to gallbladder damage. The initial clinical suspicion of liver injury was ruled out by imaging, showing the importance of thorough diagnostic testing

Isolated gallbladder perforation from blunt trauma accounts for only about 2% of all abdominal injuries requiring surgery, making it very uncommon. Most cases of gallbladder injury are associated with other organ damage, so a pure gallbladder perforation is particularly rare. This case is consistent with medical literature showing that gallbladder injuries are often diagnosed late because symptoms are non-specific and doctors don’t always think to look for them

This is a single case report, so it describes only one patient’s experience and cannot be generalized to all people with similar injuries. The patient’s intoxication at the time of injury makes it unclear how much alcohol contributed to the gallbladder rupture versus the force of the trauma itself. There is no comparison group or follow-up data beyond the initial hospital discharge

The Bottom Line

If you experience severe upper right belly pain after blunt abdominal trauma, seek emergency medical care immediately. Make sure doctors are aware of any alcohol use, as it may increase gallbladder vulnerability. Imaging with CT scan should be performed if gallbladder injury is suspected. Surgical removal of the gallbladder (cholecystectomy) is the definitive treatment. Confidence level: High for emergency care; this is based on one case but aligns with medical best practices

Anyone who has experienced blunt abdominal trauma should be aware of this possibility, especially if they had been drinking. Healthcare providers should consider gallbladder perforation in their differential diagnosis for patients with upper right abdominal pain and signs of peritonitis (belly infection) following trauma. This is particularly important in intoxicated patients where symptoms might be attributed to alcohol rather than serious injury

In this case, the patient showed symptoms within 11 hours of injury. Recovery after surgery took about 17 days in the hospital. However, outcomes depend on how quickly the diagnosis is made and surgery is performed. Delayed diagnosis increases the risk of serious infection (peritonitis), which can be life-threatening

Want to Apply This Research?

  • If you’ve had abdominal trauma, track your symptoms daily: location and severity of pain (1-10 scale), fever, nausea, and any changes in digestion. Note the date and time of injury and any medical imaging or procedures performed
  • After abdominal trauma, avoid heavy lifting and strenuous activity until cleared by your doctor. Keep all follow-up appointments and report any new or worsening belly pain, fever, or signs of infection immediately to your healthcare provider
  • For the first month after abdominal trauma, maintain a daily log of any abdominal symptoms, energy levels, and appetite. Set reminders for follow-up appointments and medication schedules. If you notice persistent pain, fever, or other concerning symptoms, contact your doctor right away rather than waiting for a scheduled appointment

This case report describes a single patient’s experience with a rare condition and should not be used for self-diagnosis. Gallbladder perforation is a medical emergency requiring immediate professional evaluation and treatment. If you have experienced abdominal trauma and are experiencing severe pain, fever, or other concerning symptoms, seek emergency medical care immediately. This information is educational and not a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider about your specific situation.