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Blunt injury to the right hepatic duct: A rare case report.

Authors :
Al-Jawad, Mohammad
Tijan, Nawal
Kawas, Abdulmonem
Lbabidi, Nour Abdulazize
Sheikh, Alan
Alhaj, Ahmad
Source :
International Journal of Surgery Case Reports; Sep2024, Vol. 122, pN.PAG-N.PAG, 1p
Publication Year :
2024

Abstract

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. 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. 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. 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. • Extrahepatic bile duct injuries are commonly iatrogenic, typically from cholecystectomy, but can also occur from trauma. • Definitive surgical repair is the main approach for bile duct injuries (BDI) and biliary strictures, with stricture rates of 10% to 20% even in high-volume centers. • In this case, the injury was managed with Roux-en-Y anastomosis, including cholecystectomy and anastomosis between the bile duct and small intestine. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
22102612
Volume :
122
Database :
Supplemental Index
Journal :
International Journal of Surgery Case Reports
Publication Type :
Academic Journal
Accession number :
179463385
Full Text :
https://doi.org/10.1016/j.ijscr.2024.110082