Int J Surg Case Rep. 2024 Jul 29;122:110082. doi: 10.1016/j.ijscr.2024.110082. Online ahead of print.
ABSTRACT
INTRODUCTION: Extrahepatic bile duct injuries can occur after abdominal trauma, though more commonly they are iatrogenic. Definitive surgical repair is the mainstay of treatment but has a significant incidence of complications, particularly when managed by non-specialist surgeons or with delayed referral to a specialized center.
CASE PRESENTATION: A 17-year-old male presented with a blunt abdominal injury after a fall, resulting in a right hepatic duct injury that was managed with a Roux-en-Y hepaticojejunostomy. Despite the initial surgical repair, the patient developed a bile leak and fluid collections, requiring a second laparotomy for drainage and lavage, with a favorable outcome at a 6-month follow-up.
DISCUSSION: Traumatic extrahepatic biliary injuries, though uncommon, can have variable etiologies, with blunt trauma being more prevalent in the pediatric population and associated with higher mortality. In the current case, prompt diagnosis and surgical management with a Roux-en-Y hepaticojejunostomy led to a favorable outcome for the patient presenting with a right hepatic duct injury.
CONCLUSION: Injuries to the common hepatic duct are uncommon, but the potential for concomitant injuries to the right or left hepatic ducts should be carefully considered when determining the appropriate surgical management for complex extrahepatic biliary tract trauma.
PMID:39079401 | DOI:10.1016/j.ijscr.2024.110082
