Stricture of the Bile Duct after Blunt Abdominal Injury: A Difficult Diagnosis

Masaru Saitoh, Hirohiko Onoyama, Koji Nishimura, Ken Sagayama, Masanori Takahashi, Tamon Nakaji, Shintaro Takao, Yoshinari Hashimoto, Yasutomo Azumi and Tomoaki Urakawa

Department of Surgery, Saiseikai Nakatsu Hospital

This parer describes a case of traumatic choledochal stenosis of which diagnosis was difficult to differentiate from malignant disease. A 70-year old man had a traffic accident with fracture of the ulnar bone but without abdominal symptom. Two weeks after the accident he developed obstructive jaundice. Ultrasonography and computed tomography revealed no findings of tumor. However, percutaneous transhepatic cholangiography showed lower bile duct stenosis which persisted continued 4 weeks after biliary drainage. Cytology of the bile jiuce was suggestive of cancer. He underwent pancreaticoduodenectomy with a diagnosis of lower bile duct cancer. However, the surgical specium and histology showed stricture of bile duct due to blunt abdominal injury.

Key words
blunt abdominal trauma, bile duct injury, biliary tract

Reprint requests
Masaru Saitoh Department of Surgery, Saiseikai Nakatsu Hospital 2-10-39 Shibata, Kita-ku, Osaka, 530-0012 JAPAN

Accepted
October 31, 2000

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