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KMID : 1033220210110030137
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Journal of Acute Care Surgery
2021 Volume.11 No. 3 p.137 ~ p.140
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An Unusual Recurrent Bile Leak Following High Grade Liver Trauma
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Jones Morgan E.
Ban Ee-Jun
Pilgrim Charles H. C.
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Abstract
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Non-operative management of blunt liver injury has been demonstrated as a safe and effective treatment for most grades of injury. As the severity of liver injury increases, so does the risk of complications. A 21-year-old male was brought to the trauma center following a high speed motorbike accident. He underwent a laparotomy and angioembolization for a Grade 4 liver injury. A biloma was diagnosed on Day 18 post injury, and he underwent Endoscopic Retrograde Cholangiopancreatography and biliary stenting which were unsuccessful. There were 2 re-admissions for infected perihepatic collections. In this case, an Endoscopic Retrograde Cholangiopancreatography was not a helpful procedure due to a disconnected liver segment, and morbidity occurred due to instrumentation of the biliary tree (the likely cause of infected biloma). Hepatic resection should be considered for patients who fail non-operative management. Further assessment of efficacy using a larger dataset for analysis is required.
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KEYWORD
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bile, endoscopic retrograde cholangiopancreatography, laparotomy, liver, trauma, wounds
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