Delayed diagnosis and successful management of completely transected common hepatic duct in a blunt multitrauma patient Künt multi-travma olgusunda teşhisi gecikmiş tam kat ana hepatik kanal yaralanmasının başarılı yönetimi


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Köstek M., Bostancı Ö., Bilgiç T., Battal M.

Ulusal Travma ve Acil Cerrahi Dergisi, cilt.28, sa.1, ss.116-119, 2022 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 28 Sayı: 1
  • Basım Tarihi: 2022
  • Doi Numarası: 10.14744/tjtes.2020.22903
  • Dergi Adı: Ulusal Travma ve Acil Cerrahi Dergisi
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.116-119
  • Anahtar Kelimeler: Abdominal injuries, common hepatic duct, hepaticostomy
  • İstanbul Yeni Yüzyıl Üniversitesi Adresli: Hayır

Özet

Extrahepatic 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.