Benefits of early diagnosis and preemptive treatment of biliary tract complications after major blunt liver trauma in children

Traumatic pediatric bile duct injury: nonoperative intervention as an alternative to surgical intervention

“…However, associated bile duct injuries remain as difficult challenges. The diagnosis is difficult and usually missed, initially resulting in substantial morbidity and prolonged hospitalization and has led to death in some cases [1][2][3][4][5][6][7][8][9][10][11].…”

“…With the advancements in endoscopy and interventional radiology, few case reports have demonstrated the benefits of nonoperative approaches [2,6,7,9,[12][13][14][15][16].…”

Jackson Pratt drain fluid-to-serum bilirubin concentration ratio for the diagnosis of bile leaks

“…Liver injury often is encountered after blunt abdominal trauma, with damage to either the intrahepatic or extrahepatic biliary tree. 5 Penetrating abdominal injuries as well commonly result in liver injury. These patients require a ''damage-control'' laparotomy that may proceed in stages along with other modalities.…”

Computed tomographic cholangiography in the diagnosis of bile duct injury in children

“…2 Delay in diagnoses is associated with substantial morbidity-notably, intraperitoneal sepsis, endotoxemia, and a hemorrhagic diathesis. 3,4 Deterioration or failure to improve in a hemodynamically stable patient with signs of peritoneal irritation should suggest a diagnosis of concomitant injury to the extrahepatic biliary tree. 5 Laparoscopic evaluation of the peritoneal cavity in this situation with drain placement is an effective method of evaluating the injury but more importantly containing the bile leak.…”