Figure 11c. Gallbladder rupture and transection of the cystic artery due to massive blunt trauma in a 6-year-old boy after a motor vehicle collision. (a) Axial contrast-enhanced CT scan shows extensive liver lacerations and right adrenal hemorrhage. Note the collection of iodinated contrast material anterior to the portal vein (arrowheads); this finding indicates active hemorrhage due to disruption of the cystic artery. (b) Axial contrast-enhanced CT scan shows noncontinuous enhancement of the gallbladder mucosa (arrowheads). Note the active extravasation of contrast material (arrows). (c) Axial contrast-enhanced CT scan shows dense intraperitoneal fluid (*), which is consistent with hemorrhage. Gallbladder rupture, hemoperitoneum, and transection of the cystic artery were confirmed at laparotomy. The patient underwent cholecystectomy.