A Case Report of Endoscopic Management of Traumatic Intrahepatic Bile Duct Injury

Introduction: Penetrating Abdominal Trauma is less common than Blunt Abdominal Trauma in India. The clinical appearance of bile duct injuries is highly variable and depends primarily on the underlying cause.

Case: We present a case of a stab injury ie penetrating abdominal injury who developed AAST grade III hepatic injury, for which exploratory laparotomy with perihepatic packing was done as patient was hemodynamically unstable and an abdominal drain was also placed. Bilious drain was seen on fifth post-operative day, which was managed by Endoscopic Retrograde Cholangiopancreatography (ERCP) with sphincterotomy and 7 Fr x 10 cm stent placed up to distal right main hepatic duct. Bile leak stopped after ERCP.

Discussion: Traumatic biliary tree injury should be kept in consideration when dealing with trauma patients. Surgeons should bear in mind the good success rates of ERCP to avoid more morbid procedures, unless indicated.