Isolated common hepatic duct perforation after blunt abdominal trauma: a case report
Engin Yılmaz 1, İbrahim Karaman 2, Çağatay Evrim Afşarlar 2, Ayşe Karaman 2, İsmet Faruk Özgüner 2
1Bakırköy Dr. Sadi Konuk Eğitim ve Araştırma Hastanesi, İstanbul
2Dr. Sami Ulus Kadın Doğum, Çocuk Sağlığı ve Hastalıkları Eğitim ve Araştırma Hastanesi, Ankara
Keywords: Trauma, hepatic duct, perforation, child
Abstract
Biliary duct injuries after blunt abdominal trauma is extremely rare and the diagnosis is difficult. It is often associated with other organ injuries. Here we present a patient with isolated common hepatic duct perforation solely following blunt abdominal trauma.
1.5 year-old girl was admitted complaining of progresively increasing abdominal pain for the last 3 days. Detailed history indicated that she had fallen down from a seat. Ultrasonography and computed tomography findings were normal except free fluid in the abdomen. Paracentesis revealed bilious fluid, and an emergency surgery was undertaken. Surgical intervention revealed a 3 mm size perforation on the posterior of the common hepatic duct and cystic duct juntion, and no other abnormality on exploration. T-tube was placed through the perforation site, and was withdrawn on postoperative 21st day. Follow-up period was uneventful.
In conclusion, meticulous query is essential for all patients with trauma, and diagnostic studies should be planned accordingly. In cases of biliary duct injuries encountered in childhood, T tube drainage of the biliary system should be considered. It is an easy and reliable practice with successful results.