J Korean Soc Traumatol.  2017 Dec;30(4):231-234. 10.20408/jti.2017.30.4.231.

Isolated Common Hepatic Duct Injury after Blunt Abdominal Trauma

• Park YC
• Jo YG
• Kang WS
• Park EK
• Kim HJ
• Kim JC

• KMID: 2405292
• DOI: http://doi.org/10.20408/jti.2017.30.4.231

Abstract

Extrahepatic bile duct injury is commonly associated with hepatic, duodenal, or pancreatic injuries, and isolated extrahepatic bile duct injury is rare. We report a patient who presented with an isolated extrahepatic bile duct injury after blunt trauma. A 50-year-old man was referred to our hospital after having suffered a fall down injury. His laboratory findings showed hyperbiliribinemia with elevated aspartate aminotransferase and alanine aminotransferase level. Initial abdominal computed tomography (CT) showed a mild degree of hemoperitoneum without evidence of abdominal solid organ injury. On the 3rd day of hospitalization, the patient complained of dyspnea and severe abdominal discomfort. Follow-up abdominal CT showed no significant interval change. Owing to the patient's condition, Emergency laparotomy revealed a large amount of bile-containing fluid collection and about 1 cm in size laceration on the left lateral side of the common hepatic duct. Primary repair of the injured bile duct with T-tube insertion was performed On postoperative day (POD) 30, endoscopic retrograde cholangiopancreatography showed minimal bile leakage and endoscopic sphincteroplasty and endoscopic retrograde biliary drainage were performed. On POD 61, the T-tube was removed and the patient was discharged.

Keyword

Abdominal injuries; Hepatic duct

MeSH Terms

Abdominal Injuries
Alanine Transaminase
Aspartate Aminotransferases
Bile
Bile Ducts
Bile Ducts, Extrahepatic
Cholangiopancreatography, Endoscopic Retrograde
Drainage
Dyspnea
Emergencies
Follow-Up Studies
Hemoperitoneum
Hepatic Duct, Common*
Hospitalization
Humans
Lacerations
Laparotomy
Middle Aged
Tomography, X-Ray Computed
Alanine Transaminase
Aspartate Aminotransferases