A case of complete transection of the common bile duct due to blunt trauma

Abstract

A 20-year-old woman had a traffic accident, while driving a car with her seat belt fastened. An air bag was deployed during the accident. She sustained a right femoral fracture and CT showed ascites collection, injuries of the liver, spleen and pancreas. Emergency interventional radiology did not show any extravasation from these organs. Non-operative management was performed for 8 days, when peritonitis with severe abdominal pain developed. CT detected circumscribed fluid collection in the omental bursa. Biliary peritonitis with common bile duct injury was diagnosed, and emergency surgery was performed. The common bile duct was completely transected, and choledochojejunostomy was performed. The postoperative course was good. Extrahepatic biliary tract injury due to blunt trauma is rare and it was initially difficult to diagnose this injury. It often occurs in complete transection. © 2011 The Japanese Society of Gastroenterological Surgery.