pmc logo image
Logo of westjmedLink to Publisher's site

Formats:

West J Med. 1981 April; 134(4): 283–289.
PMCID: PMC1272680
Extrahepatic Biliary Duct Trauma
A Spectrum of Injuries
Todd B. Burt, MD and James A. Nelson, MD
Department of Radiology, University of Utah College of Medicine, Salt Lake City
Abstract
Blunt traumatic injury of the extrahepatic bile ducts (EBD) is uncommon. Familiarity with the wide spectrum of possible EBD injuries is essential, however, because of the increasing number of nonpenetrating abdominal injuries seen in modern society. These injuries include contusion with edema, hematoma and varying degrees of laceration. Edema and hematoma can result in transient bile duct obstruction that clears spontaneously or cicatrizing inflammatory reaction resulting in stricture and obstruction. Common bile duct stricture following blunt trauma is extremely rare, but is an unfortunate late complication requiring biliary decompression to relieve progressive jaundice. Laceration (partial or complete) can occur at any location in the EBD and can be life-threatening if the diagnosis is overlooked. Hemobilia is an unusual complication of laceration of the EBD. Failure to recognize the clinical manifestations of these uncommon injuries results in delayed and often incorrect diagnoses. Percutaneous transhepatic cholangiography is a safe and accurate procedure that is an important step in the workup of jaundice following blunt trauma.
Full text
Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.7M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.
Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
  • Champion HR, Jones RT, Trump BF, Decker R, Wilson S, Stega M, Nolan J, Crowley RA, Gill W. Post-traumatic hepatic dysfunction as a major etiology in post-traumatic jaundice. J Trauma. 1976 Aug;16(08):650–657. [PubMed]
  • Seror J, Schmitt JC, Pateras C, Sava G. Operative injuries to the bile ducts. Report on 12 cases. Int Surg. 1978 Feb;63(2):108–113. [PubMed]
  • Hillis TM, Westbrook KC, Caldwell FT, Read RC. Surgical injury of the common bile duct. Am J Surg. 1977 Dec;134(6):712–716. [PubMed]
  • Howard RJ, Delaney JP. Postoperative cholecystitis. Am J Dig Dis. 1972 Mar;17(3):213–218. [PubMed]
  • DuPriest RW, Jr, Khaneja SC, Cowley RA. Acute cholecystitis complicating trauma. Ann Surg. 1979 Jan;189(1):84–89. [PMC free article] [PubMed]
  • Foley LC, Teele RL. Ultrasound of epigastric injuries after blunt trauma. AJR Am J Roentgenol. 1979 Apr;132(4):593–598. [PubMed]
  • Lewis KM. TRAUMATIC RUPTURE OF THE BILE DUCTS. Ann Surg. 1938 Aug;108(2):237–242. [PMC free article] [PubMed]
  • MASON LB, SIDBURY JB, GUIANG S. Rupture of the extrahepatic bile ducts from nonpenetrating trauma. Ann Surg. 1954 Aug;140(2):234–241. [PMC free article] [PubMed]
  • MOHARDT JH. Traumatic rupture of the common bile duct; report of a case and review of the literature. Q Bull Northwest Univ Med Sch. 1956;30(1):16–20. [PubMed]
  • Fish JC, Johnson GL. Rupture of Duodenum following Blunt Trauma: Report of a Case with Avulsion of Papilla of Vater. Ann Surg. 1965 Nov;162(5):917–919. [PMC free article] [PubMed]
  • Rydell WB., Jr Complete transection of the common bile duct due to blunt abdominal trauma. Arch Surg. 1970 Jun;100(6):724–728. [PubMed]
  • FLETCHER WS, MAHNKE DE, DUNPHY JE. Complete division of the common bile duct due to blunt trauma. Report of a case and review of the literature. J Trauma. 1961 Mar;1:87–95. [PubMed]
  • Parkinson SW, Wisniewski ZS. Avulsion of the ampulla of Vater: an isolated injury following blunt abdominal trauma. Aust N Z J Surg. 1978 Oct;48(5):562–564. [PubMed]
  • Balsano NA, Reynolds BM. Rupture of the common duct and ampulla of Vater due to blunt trauma. Ann Surg. 1973 Aug;178(2):200–203. [PMC free article] [PubMed]
  • Tonnesen P. Rupture of extra-hepatic biliary ducts from blunt external trauma. Dan Med Bull. 1970 Oct;17(8):238–245. [PubMed]
  • Janss G, Freimark L. Isolated transection of the common duct. JACEP. 1979 Apr;8(4):161–163. [PubMed]
  • Sinclair MC, Moore TC, Asch MJ, Brosman SA. Injury to hollow abdominal viscera from blunt trauma in children and adolescents. Am J Surg. 1974 Nov;128(5):693–698. [PubMed]
  • Shorthouse AJ, Singh MP, Treasure T, Franklin RH. Isolated complete transection of the common bile duct by blunt abdominal trauma. Br J Surg. 1978 Aug;65(8):543–545. [PubMed]
  • Zollinger RM, Jr, Keller RT, Hubay CA. Traumatic rupture of the right and left hepatic ducts. J Trauma. 1972 Jul;12(7):563–569. [PubMed]
  • Turney WH, Lee JP, Raju S. Complete transection of the common bile duct due to blunt ranuma. Ann Surg. 1974 Apr;179(4):440–444. [PMC free article] [PubMed]
  • Parkinson SW. Complete severance of the common bile duct due to blunt trauma. Aust N Z J Surg. 1970 Feb;39(3):253–254. [PubMed]
  • Caro AM, Losa JM. Complete avulsion of the common bile duct as a result of blunt abdominal trauma--case report of a child. J Pediatr Surg. 1970 Feb;5(1):60–62. [PubMed]
  • Haynes CD, Given KS, Stone HH, Smith RB., 3rd Nonsurgical trauma to the extrahepatic bile ducts. South Med J. 1969 Nov;62(11):1323–1326. [PubMed]
  • Moffat RC, Lucas RJ. Transection of the common bile duct as an isolated injury following blunt trauma. Can J Surg. 1969 Jul;12(3):334–335. [PubMed]
  • Longmire WP, Jr, McArthur MS. Occult injuries of the liver, bile duct, and pancreas after blunt abdominal trauma. Am J Surg. 1973 Jun;125(6):661–666. [PubMed]
  • Fullen WD, Selle JG, Whitely DH, Martin LW, Altemeier WA. Intramural duodenal hematoma. Ann Surg. 1974 May;179(5):549–556. [PMC free article] [PubMed]
  • Maull KI, Fallahzadeh H, Mays ET. Selective management of post-traumatic obstructing intramural hematoma of the duodenum. Surg Gynecol Obstet. 1978 Feb;146(2):221–224. [PubMed]
  • IZANT RJ, Jr, DRUCKER WR. DUODENAL OBSTRUCTION DUE TO INTRAMURAL HEMATOMA IN CHILDREN. J Trauma. 1964 Nov;4:797–813. [PubMed]
  • Resnicoff SA, Morton JH. Changing concepts concerning intramural duodenal hematomas. J Trauma. 1969 Jul;9(7):561–576. [PubMed]
  • Davis DR, Thomas CY. Intramural Hematoma of the Duodenum and Jejunum: A Cause of High Intestinal Obstruction-Report of Three Cases due to Trauma. Ann Surg. 1961 Mar;153(3):394–398. [PMC free article] [PubMed]
  • PARRISH RA, EDMONDSON HT, MORETZ WH. DUODENAL AND BILIARY OBSTRUCTION SECONDARY TO INTRAMURAL HEMATOMA. Am J Surg. 1964 Sep;108:428–430. [PubMed]
  • FERGUSON IA, Jr, GOADE WJ., Jr Intramural hematoma of the duodenum; report of a case. N Engl J Med. 1959 Jun 4;260(23):1176–1177. [PubMed]
  • FELSON B, LEVIN EJ. Intramural hematoma of the duodenum: a diagnostic roentgen sign. Radiology. 1954 Dec;63(6):823–831. [PubMed]
  • Skow JR, Longmire WP., Jr Common duct stricture secondary to blunt abdominal trauma. Am Surg. 1974 Oct;40(10):576–578. [PubMed]
  • Sandblom P, Mirkovitch V, Saegesser F. Formation and fate of fibrin clots in the biliary tract: a clinical and experimental study. Ann Surg. 1977 Mar;185(3):356–366. [PMC free article] [PubMed]
  • Oparah SS, Mandal AK. Traumatic thoracobiliary (pleurobiliary and bronchobiliary) fistulas: clinical and review study. J Trauma. 1978 Jul;18(7):539–544. [PubMed]