A Case of Common Bile Duct Stenosis after Bile Peritonitis Due to Nonpenetrating Abdominal Trauma

Satoshi Ushijima, Tomohiko Ikeya, Katsumi Kiyosaki, Hidenori Maruoka, Fumika Hanadate, Rinichiroh Wakasa, Shuichi Murata

Division of Surgery, Himi Municipal Hospital

Rupture of the bile duct or bile duct stenosis is a rare complication of nonpenetrating trauma. A case of common bile duct stenosis after rupture of the bile due to nonpenetrating trauma is presented. A 47-year-old man was referred to our hospital with the complain of abdominal pain. He was involved in a motor accident and sustained severe trauma to the abdomen. Findings of abdominal computed tomography suggested liver injury and he was given conservative treatment. But he experienced high fever and the abdominal pain gradually increased. A laparotomy was performed on the 32nd day after the injury. There was about 5200 ml of bile-stained fluid in the peritoneal cavity. Careful exploration revealed no obvious injury to the bile duct and he was treated only by inserion of serveral drains. He became jaundiced in the 4th month after the injury. Further examinations revealed complete obstruction of the lower bile duct. A balloon dilatation after percutaneous transhepatic biliary drainage was unsuccessful. A second operation, cholecystectomy and choledochoduodenostomy, was performed on the 235th day after the injury. The postoperative course was quite uneventful and the patient remains clinically well 11 months after the operation.

Key words
traumatic rupture of the bile duct, benign stenosis of the common bile duct, choledochoduodenostomy

Reprint requests
Satoshi Ushijima Division of Surgery, Himi Municipal Hospital
31-9 Saiwaichou, Himi-City, 935 JAPAN

Accepted
June 13, 1990

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