Intrahepatic Bile Duct Rupture Following Blunt Abdominal Trauma

Charters, A C; Bardin, Joshua A.

doi:10.1001/archsurg.1978.01370190095018

Cited by 7 publications

(1 citation statement)

References 11 publications

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“…The CBD was not visible. Below the liver in the retroperitoneum extending downwards almost to the pelvis a large septate encapsulated anechoic fluid collection 15 15 cm in diameter was demonstrated ( Figures 1, 2, 3). The pancreas, spleen and kidneys were normal.…”

Section: Case Reportmentioning

confidence: 98%

Retroperitoneal Biloma Secondary to Operative Common Bile Duct Injury

Colović

Perisić-Savić

1990

HPB Surgery

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Encapsulated collections of bile ("biloma") may be a sequela of liver trauma, operative injury or disease. Such collections may be intrahepatic or extrahepatic and usually in the supramesocolic compartment of the abdomen. This is a report of a retroperitoneal biloma, an entity that has been reported only twice to date but this is the first secondary to an operative common bile duct lesion.Evacuation of the biloma and reconstruction of the associated biliary stricture were successfully carried out. The patient remains sympton free with normal clinical and laboratory data more than 14 months after surgery.Operative common bile duct (CBD) injury may be followed by a number of complications. To our knowledge retroperitoneal biloma secondary to a CBD lesion has not been previously reported. CASE REPORTA 54 year old lady was submitted to elective cholecystectomy in a district hospital on 15/09/1988. Operative cholangiography was not performed. Soon after operation bile drainage through a subhepatic drain appeared and continued for four weeks. The patient subsequently developed bile peritonitis and was reoperated upon on 21/10/1988 and the abdominal cavity was drained. Bile drainage stopped by mid-January 1989 but was followed by jaundice. A third operation was performed on 23/02/89 for obstructive jaundice. The CBD could not be found and the abdomen was closed with drainage. In March 1989 percutaneous transhepatic cholangiography (PTC) was carried out clearly demonstrating a high CBD stricture. The procedure was followed by frequent attacks of severe cholangitis with a temperature of up to 40C.. Once while vomiting she felt "that something broke in the abdomen". After this episode the fever abated somewhat and the attacks of cholangitis became less severe. However, a painful enlarging right lower quadrant abdominal mass appeared.At the time of admission to our Institution on 31/03/1989 she was deeply jaundicied with a large tender right lower abdominal mass. Laboratory data indicated biliary obstruction (total serum bilirubin 302.5 mmol/l, serum alkaline phosphatase 6.9 U/I (normal value 1 to 2.5 U/l).

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Section: Case Reportmentioning

confidence: 98%

Retroperitoneal Biloma Secondary to Operative Common Bile Duct Injury

Colović

Perisić-Savić

1990

HPB Surgery

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Non-surgical trauma to the extrahepatic biliary tract

Parks

Diamond

1995

Journal of British Surgery

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Non-surgical trauma to the extrahepatic biliary tract is uncommon and encountered only rarely by surgeons outside specialist hepatobiliary centres. Such injury often results in significant morbidity and mortality. This review outlines the incidence, classification, mechanisms of injury, presentation, diagnostic techniques and management options. Depending on the type of biliary injury identified, an optimal method of repair is suggested. Recommendations are made for surgeons who encounter this type of injury and do not have the appropriate expertise for definitive management.

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