Nonoperative management of biliary tract fistulas after blunt abdominal trauma in a child

J Pediatr Surg. 1995 Dec;30(12):1719-21. doi: 10.1016/0022-3468(95)90463-8.

Abstract

Nonoperative treatment was carried out in a 12-year-old girl who presented with biliary fistulas after blunt abdominal trauma with hepatic injury. A computed tomography-guided percutaneous puncture showed biliary peritonitis and permitted the positioning of an efficient intraperitoneal drainage. Endoscopic retrograde cholangiography was very helpful for visualization and accurate localization of biliary injuries. This permitted positioning a nasobiliary drain to reduce intrabiliary pressure and to bypass a lesion of the common hepatic duct. This nonoperative management allowed healing of fistulas within 20 days, without bile duct stricture (noted on the follow-up intravenous cholangiogram 18 months later).

Publication types

  • Case Reports

MeSH terms

  • Abdominal Injuries / diagnostic imaging
  • Abdominal Injuries / therapy*
  • Bile Ducts, Intrahepatic / diagnostic imaging
  • Bile Ducts, Intrahepatic / injuries*
  • Biliary Fistula / diagnostic imaging
  • Biliary Fistula / therapy*
  • Child
  • Cholangiography
  • Cholangiopancreatography, Endoscopic Retrograde
  • Diagnosis, Differential
  • Female
  • Follow-Up Studies
  • Humans
  • Liver / diagnostic imaging
  • Liver / injuries*
  • Tomography, X-Ray Computed
  • Wound Healing / physiology
  • Wounds, Nonpenetrating / diagnostic imaging
  • Wounds, Nonpenetrating / therapy*