The "flying" bile duct: avulsion of the common bile duct in a plane crash survivor.
Affiliation
Department of Surgery, St. Vincent's University Hospital, Dublin, Ireland., eibhlinmohan@hotmail.comIssue Date
2012-02-01T10:30:58ZMeSH
*Accidents, AviationCommon Bile Duct/*injuries
Humans
Male
Middle Aged
Wounds, Nonpenetrating/*complications/*surgery
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Show full item recordCitation
Ir J Med Sci. 2009 Dec;178(4):523-5.Journal
Irish journal of medical scienceDOI
10.1007/s11845-008-0225-0PubMed ID
18839268Abstract
Blunt trauma is an unusual cause of extrahepatic bile duct injury. This is a case of a 51-year-old gentleman who sustained a significant seatbelt injury in a plane crash. Laparotomy, performed due to persistent abdominal pain, revealed that the common bile duct (CBD) was completely avulsed from the duodenum. Following insertion of drains and transfer to a hepatobiliary centre, the devascularised CBD was excised and replaced with a roux-en-y hepaticojejunostomy. Necrotic tissue was debrided from the pancreatic head. A persistent bile leak developed from the sub-hepatic drain. Repeat laparotomy revealed a bile leak from small ducts on the liver surface. Ligation of the ducts and bioglue sealing of the area were successfully performed. Subsequent to this a pancreatic fistula developed from the main pancreatic duct, which has since resolved. This unusual case illustrates the need for prompt recognition and early repair to optimise outcomes in traumatic CBD injury.Language
engISSN
1863-4362 (Electronic)0021-1265 (Linking)
ae974a485f413a2113503eed53cd6c53
10.1007/s11845-008-0225-0
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