Extrahepatic bile duct injury in blunt trauma: A systematic review

Pereira, Ryan; Vo, Tovi; Slater, Kellee

doi:10.1097/ta.0000000000002186

Cited by 9 publications

(15 citation statements)

References 24 publications

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“…[8] [10] In some cases, abundant free uid without a sharp drop in hemoglobin can be a guide to diagnosing extrahepatic bile duct damage. [8] Our patient presented with similar conditions a few days after discharge. In many of these patients, laboratory changes, such as an increase in bilirubin blood levels, are attributed to factors such as blood transfusions or the process of absorption of the hematoma.…”

Section: Discussionsupporting

confidence: 53%

“…In cases undergoing conservative treatment, a delay of about 11 days in diagnosis has been reported. [8] The reason for the delay in diagnosis is probably because the bile leak is mistaken for bleeding from blunt abdominal trauma in hemodynamically stable patient. Porta hepatis hematoma reported in some cases of extra hepatic biliary tree injuries in our case Hepatic artery injury was suggested as the cause of hematoma.…”

Section: Discussionmentioning

confidence: 99%

“…[6] [7] The most common site of injury to the extrahepatic bile duct is where the common bile ducts enter the pancreas. [8] Case Presentation A 23-year-old man who referred to General Hospital in down town of Tehran due to severe trauma in rollover motorcycle accident. There was no evidence of hemodynamic instability in emergency department.…”

Section: Back Groundmentioning

confidence: 99%

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Simultaneous Damage to the Hepatic Artery and Common Bile Duct in a Blunt Abdominal Trauma: A Case Report

Mansoorian¹,

Babaei²,

Nikkhah³

et al. 2021

Preprint

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Background: Diagnosis and management of extrahepatic duct injuries in blunt abdominal trauma is very difficult and challenging. First because these injuries are very rare. Also, in the management of abdominal blunt trauma, many patients are currently managed with non-surgical and conservative methods. Case presentation: A 23-year-old man who referred to General Hospital in down town of Tehran due to severe trauma in rollover motorcycle accident. There was no evidence of hemodynamic instability in emergency department. There was a drop in hemoglobin in the first week of hospitalization, which could be due by hepatic artery injury. We decided to manage hepatic artery pseudo aneurysm with interventional radiology approach. On angiography, a picture of a thrombotic pseudoaneurysm was seen, which was embolized by passing a catheter and endovascular coiling. Four days later, he presented with severe abdominal distension. In the study, the abdomen was full of fluid, which was emptied, and about 5 liters of bile were expelled. Twenty-four days after the accident, the patient underwent ERCP and a clear leak of proximal part CBD was evident. CBD stent was inserted under the guide of fluoroscopy. The patient underwent complete intravenous nutrition and the volume of discharge did not decrease during treatment. One week after starting intravenous feeding, the patient developed fever, tachycardia, and abdominal tenderness, so he underwent surgery. Severe adhesions and multiple collections were evident in the abdomen. Abdominal lavage was performed and two right and left sub-diaphragmatic drains were inserted and the abdomen was closed. Enteral feeding began 5 days after the surgery and the patient was discharged in good general condition. Conclusions: This is a rare case of simultaneous hepatic artery and common bile duct injury at the same time which manage with interventional embolization for hepatic artery pseudoaneurysm and ERCP and stenting also total parenteral nutrition for common bile duct injury at first step. At last surgery was done due to control the sepsis and abdominal collections drainage.

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Back Groundmentioning

confidence: 99%

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Simultaneous Damage to the Hepatic Artery and Common Bile Duct in a Blunt Abdominal Trauma: A Case Report

Mansoorian¹,

Babaei²,

Nikkhah³

et al. 2021

Preprint

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“…The incidence of ischaemic intrahepatic bile duct injury following liver transplantation is 5-19% [8]. These are characterized by nonanastomotic biliary strictures and dilatation in graft tissue, which occur mostly within six months from post-liver transplant [10]. Intrahepatic bile duct injury may lead to bile leakage, ascites, biloma, hemobilia, and abscess [1,5,11].…”

Section: Discussionmentioning

confidence: 99%

Utilization of a Reduced Graft from a Severely Traumatized Liver: A Case Report and Strategy to Increase Availability of Livers for Transplant

Imai¹,

Kumaran²,

Bruno³

et al. 2021

SCR

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Background: Trauma victims with liver lacerations in the hilum are typically excluded from liver donation. We report a case of a successful liver transplant from a deceased donor with a grade 4 hilar liver laceration. Case Presentation: We used a liver with a high-grade laceration from a 28-year-old brain-dead traffic accident victim. The liver had grade IV lacerations in the right and caudate lobes. In situ split liver technique was applied to control the lacerations after an intraoperative cholangiogram revealed favourable anatomy. The left hemi-liver graft was procured, retaining the entire vena cava and the full length of the main hepatic vasculature. The recipient was a 62-year-old female patient with end-stage liver disease, with a Model for End-Stage Liver Disease-Sodium score of 19. The left lobe graft was transplanted using the standard piggy-back technique. The patient was discharged on postoperative day 7 after an uneventful recovery. At two-month follow-up, she continues to do well, with normal hepatic function and unremarkable imaging studies. Conclusion: This is the first reported case of a successful liver transplant of a severely lacerated liver made possible by the application of split liver techniques. In situ splitting of a severely traumatized liver could permit the utilization of a reduced graft for small recipients.

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“…Isolated EHBDI is rare in clinical practice, and has rarely been reported in the literature. The author retrieved 204 studies involving EHBDI in the last 10 years from PubMed, of which only 23 were about isolated EHBDI, most of which were case reports that were mostly combined with injuries, only 1 systematic review[ 4 ] and 2 summaries of complications[ 5 , 6 ]. A study involving 1873 patients with blunt abdominal injuries reported only 7 cases of EHBDI[ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Rare isolated extra-hepatic bile duct injury: A case report

Zhao

Dang

Lin

et al. 2021

WJCC

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BACKGROUND Extra-hepatic bile duct injury (EHBDI) is very rare among all blunt abdominal injuries. According to literature statistics, it only accounts for 3%-5% of abdominal injuries, most of which are combined injuries. Isolated EHBDI is more rare, with a special injury mechanism, clinical presentation and treatment strategy, so missed diagnosis easily occurs. CASE SUMMARY We report a case of unexplained abdominal effusion and jaundice following blunt abdominal trauma in our department. Of which, surgical exploration of the case was performed and a large amount of bile leakage in the abdominal cavity was found. No obvious abdominal organ damage or bile duct rupture was found. Surgery was terminated after the common bile duct indwelled with a T tube. After 2 wk, a T-tube angiography revealed the lesion in the common bile duct pancreatic segment, confirming isolated EHBDI. And 2 mo later, the T tube was pulled out with re-examined magnetic resonance cholangiopancreatography, indicating narrowing of the common bile duct injury, with no special treatment due to no clinical symptoms and no abnormality in the current follow-up. CONCLUSION This case was featured by intraoperative bile leakage and no EHBDI. This type of rare isolated EHBDI is prone to missed and delayed diagnosis due to its atypical clinical manifestations and imaging features. Surgery is still the main treatment, and the indications and principles of bile duct injury repair must be followed.

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Extrahepatic bile duct injury in blunt trauma: A systematic review

Cited by 9 publications

References 24 publications

Simultaneous Damage to the Hepatic Artery and Common Bile Duct in a Blunt Abdominal Trauma: A Case Report

Simultaneous Damage to the Hepatic Artery and Common Bile Duct in a Blunt Abdominal Trauma: A Case Report

Utilization of a Reduced Graft from a Severely Traumatized Liver: A Case Report and Strategy to Increase Availability of Livers for Transplant

Rare isolated extra-hepatic bile duct injury: A case report

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