A Case Report of Endoscopic Management of Traumatic Intrahepatic Bile Duct Injury
Published: 2021-06-23
Page: 426-431
Issue: 2021 - Volume 4 [Issue 2]
Amol Nanasaheb Wagh
Department of General Surgery, Grant medical College and Sir J. J. Group of Hospitals, Mumbai 400008, India.
Parth Bhavesh Gada
*
Department of General Surgery, Grant medical College and Sir J. J. Group of Hospitals, Mumbai 400008, India.
Hemant Muktaram Jawale
Department of General Surgery, Grant medical College and Sir J. J. Group of Hospitals, Mumbai 400008, India.
Snehal Milind Dandge
Department of General Surgery, Grant medical College and Sir J. J. Group of Hospitals, Mumbai 400008, India.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Penetrating Abdominal Trauma is less common than Blunt Abdominal Trauma in India. The clinical appearance of bile duct injuries is highly variable and depends primarily on the underlying cause.
Case: We present a case of a stab injury ie penetrating abdominal injury who developed AAST grade III hepatic injury, for which exploratory laparotomy with perihepatic packing was done as patient was hemodynamically unstable and an abdominal drain was also placed. Bilious drain was seen on fifth post-operative day, which was managed by Endoscopic Retrograde Cholangiopancreatography (ERCP) with sphincterotomy and 7 Fr x 10 cm stent placed up to distal right main hepatic duct. Bile leak stopped after ERCP.
Discussion: Traumatic biliary tree injury should be kept in consideration when dealing with trauma patients. Surgeons should bear in mind the good success rates of ERCP to avoid more morbid procedures, unless indicated.
Keywords: Endoscopic retrograde cholangiopancreatography, abdominal injuries, penetrating wounds