A Case of Common Bile Duct Stricture due to Blunt Abdominal Trauma

Jyunichi Takamizawa, Susumu Fujioka, Kenji Kato, Yuuichi Machiki, Yasushi Kutsuna, Yasushi Takenouchi, Shigeru Hibino, Daisuke Takara, and Katsue Yoshida^*

Departments of Surgery and Pathology^* Kiryuu Kousei General Hospital

A 37-year-old woman kicked in the abdomen by her husband experienced epigastric and back pain 1 week later. She was hospitalized 2 weeks later due to remarked icterus. Abdominal computed tomography (CT) showed the head of the pancreas to be enlarged and biliary dilation. Endoscopic retrograde chorangiopancreatography (ERCP) showed stenosis of the lower part of the bile duct with no abnormality in the main pancreas duct. An upper gastrointestinal tract (UGI) series showed no duodenal abnormality. She underwent percutaneous trsanshepatic biliary drainage (PTBD), followed by cytologic examination of the bile after blushing of biliary stenosis. Because cytology was negative, we tentatively diagnosed traumatic biliary stricture. We failed to place an endoprosthetic device in the pronounced stenosis, so she was discharged with an external drainage catheter and followed up as an outpatient.
The endoprosthetic tube was removed 4 months due to spontaneous regression of biliary stenosis observed in follow-up cholangiography. Laboratory and CT examinations have shown normal results, with conservative therapy using the PTBD catheter yielding satisfactory results.
Traumatic biliary stricture is reversible because the pathological process is of a benign inflammatory nature. Conservative strategy is therefore a viable therapeutic options in treating traumatic biliary stricture.

Key words
common bile duct stricture, blunt abdominal trauma, PTBD

Reprint requests
Jyunichi Takamizawa Division of Surgical Oncology, Department of Surgery, Nagoya University, Graduate School of Medicine 65 Tsutumai-cho, Showa-ku, Nagoya, 466-8550 JAPAN

Accepted
July 24, 2002

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