Blunt Left Extrahepatic Bile Duct Injury: Case Report and Literature Review

Mestral, Charles de; Razek, Tarek; Khwaja, Kosar; Fata, Paola

doi:10.1007/s00068-008-7102-4

Cited by 2 publications

(2 citation statements)

References 24 publications

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“…The exact mechanism of injury is unknown; however, various causes have been hypothesized to influence the process [2]. These include increased intra-ductal pressure due to compression of the gallbladder with the resultant ductal blowout, biliary tract compression against the spine due to the crushing force, and shearing of biliary tract from cephalic and caudal displacement as a result of rapid deceleration [1,3-4]. In this patient, the authors feel the following series of events occurred that led to this rare injury.…”

Section: Discussionmentioning

confidence: 99%

Crushed Confluence with Significant Tissue Loss: A Case Report of a Rare Biliary Tract Injury following Blunt Trauma Abdomen

Ahmad

Saleem

Mahmood

et al. 2019

Cureus

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Traumatic extrahepatic biliary tract injuries are rare occurrences because they are a relatively small target of injury following trauma. They are almost always associated with injuries to surrounding structures, which take precedence during initial management. The management of extrahepatic biliary tract injuries depends on the extent and level of the injury. This may include primary repair to high-level biliary-enteric anastomoses. We report a case of injury to the biliary confluence that occurred after blunt trauma abdomen. The injury was associated with an extensive liver injury that was the focus of initial treatment. We discuss the possible mechanisms that led to injury of this relatively hidden area and describe the various treatment options that can be applicable in such cases.

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Section: Discussionmentioning

confidence: 99%

Crushed Confluence with Significant Tissue Loss: A Case Report of a Rare Biliary Tract Injury following Blunt Trauma Abdomen

Ahmad

Saleem

Mahmood

et al. 2019

Cureus

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“…The incidence of extrahepatic biliary duct injury following a blunt trauma has been reported to be as low as 1 in 10.500 trauma cases [4], and complete common bile duct transection is particularly rare too [5]. There are only 46 cases of isolated extrahepatic bile duct rupture due to blunt abdominal trauma (clearly and well-documented cases without other signifi cant associated intra-abdominal injuries in English language, in PubMed) [6][7][8][9][10][11][12][13][14][15][16][17][18].…”

Section: Discussionmentioning

confidence: 99%

Intrapancreatic Lesion of Biliary Duct Following a Blunt Trauma: A Rare Entity Difficult to Identify with Conservative Management

Jiménez-Fuertes¹,

Ruíz-Tóvar²,

Durán-Poveda³

et al. 2017

Open J Trauma

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Lesions of the biliary duct following a blunt abdominal trauma occurs infrequently, and even more so when it occurs in the intrapancreatic biliary duct. With the increase of conservative treatment in blunt abdominal trauma, the diagnosis of this entity can be diffi cult and delayed. We present the case of a lesion of the intrapancreatic biliary duct following a blunt trauma. A 51-year-old male patient was treated following a bicycle accident. Initial CT scan showed multiple bilateral rib fractures and grade 2 liver injury in segment VII. On the basis of these fi ndings and the stability of the patient, a conservative treatment was adopted. On the 9 th day following admission he developed a progressive jaundice. This prompted a Doppler ultrasonography of the liver, showing no abnormalities in the pedicle or hepatic vessels, as well as an MR-cholangiography, which only revealed an increased amount of abdominal fl uid without dilatation of the bile duct and without apparent injury of the duct. Upon the onset of fever and general worsening of the patient's condition, an exploratory laparotomy was performed on the 16 th day following admission, revealing plenty of intraperitoneal bile fl uid, but a visual examination of the bile duct failed to determine the site of injury. An intraoperative ERCP was performed, revealing a lesion of the intrapancreatic bile duct, after which a biliary stent was inserted. In the early postoperative period the patient developed a leak through the external biliary drains placed during laparotomy. A new ERCP was therefore performed, together with the insertion of a coated metal prosthesis, after which the patient progressed satisfactorily. Damage to the intrapancreatic bile duct by blunt abdominal trauma is a rare entity, diffi cult to diagnose, especially with the increase of conservative treatment of associated injury such as liver damage. MR cholangiography and ERCP play a fundamental role in the diagnosis and actual endoscopic treatment of these injuries (with or without a surgical cavity wash) and, when feasible, this constitutes the best option for treatment.

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Blunt Left Extrahepatic Bile Duct Injury: Case Report and Literature Review

Cited by 2 publications

References 24 publications

Crushed Confluence with Significant Tissue Loss: A Case Report of a Rare Biliary Tract Injury following Blunt Trauma Abdomen

Crushed Confluence with Significant Tissue Loss: A Case Report of a Rare Biliary Tract Injury following Blunt Trauma Abdomen

Intrapancreatic Lesion of Biliary Duct Following a Blunt Trauma: A Rare Entity Difficult to Identify with Conservative Management

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