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Ulus Travma Acil Cer · Jan 2022
Case ReportsDelayed diagnosis and successful management of completely transected common hepatic duct in a blunt multitrauma patient.
- Mehmet Köstek, Özgür Bostancı, Tayfun Bilgiç, and Muharrem Battal.
- Department of General Surgery, University of Health Sciences Şişli Hamidiye Etfal Training and Research Hospital, İstanbul-Turkey.
- Ulus Travma Acil Cer. 2022 Jan 1; 28 (1): 116119116-119.
AbstractExtrahepatic bile duct injuries are very uncommon and easily be missed in multitrauma patients. Patients suffer from bile duct injuries need special approach to this situation. In this report, a case with total transection of common hepatic duct and treatment approach was presented. In unstable patients, damage control surgery can be applied. A 32-year-old male patient was brought to the emergency department after a beating that includes multiple blunt trauma. Radiological screening showed cranial, nasal, lumbar vertebral, and costal bone fractures, decreased blood flow to the right kidney and free perihepatic and perisplenic fluid. Neurosurgeons operated this patient at the day of admission and no plan for laparotomy was made for this patient at that time. Second day postoperatively patient was transferred to the department of surgery and exploratory laparotomy has been made. Common hepatic duct was fully transected and because of the patient's hemodynamic instability, an external fistula has been made. The patient discharged 10th day postoperatively. The patient was operated after follow-up and a Roux-en-y hepaticojejunostomy has been made. Extrahepatic bile duct injuries are rare and high suspicion is important in complex multitrauma patients. Extent of the injury is unique for every patient and technical aspect of repair can be challenging.
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