PMC3736968_01
Postmortem CT images of the abdomen showing gallbladder avulsion and associated abdominal bleeding. (a) A moderate amount of blood can be identified in the perisplenic and right perihepatic spaces (white arrows). (b) The gallbladder is missing from the liver bed. Clotted blood is confirmed in the gallbladder fossa (white arrow heads). (c) Gallstones and biliary sludge were found in the fundus of gallbladder; the fundus is located near the lower pole of the right kidney in a high-attenuation material (asterisk). (d) A sagittal image reveals complete avulsion of the gallbladder containing gallstones, with displacement of the gallbladder from its fossa so that it lies in a high-attenuation material in the inferior abdomen. (e) A coronal image also shows complete avulsion of the distended gallbladder
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ARR482898F1
On postmortem CT, a moderate amount of blood was identified in the right perihepatic and perisplenic spaces, respectively (Fig. 1a). The gallbladder could not be visualized in situ (Fig. 1b). It was lying in a high-attenuation material (suspected to be blood) in the inferior abdomen, detached from its liver bed and filled with a large amount of bile, some gallstones, and biliary sludge (Fig. 1c, d, e). Its fundus was at the lower pole of the right kidney (Fig. 1d). Clotted blood was evident in the liver bed (Fig. 1b).
Gross appearance of the liver. The gallbladder is detached from the liver bed. The liver shows signs of cirrhosis
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ARR482898F2
The distended gallbladder was completely stripped from its liver bed (Fig. 2) and hanging from an intact cystic duct with adherent coagulated material.