gallbladder trauma due to car accident signs

Gallbladder trauma due to car accident signs driver#
Gallbladder trauma due to car accident signs full#

Several workers have suggested that endoscopic stent placement is an effective treatment for suprapancreatic biliary strictures caused by blunt abdominal trauma. To prevent irreversible fibrosis, an early diagnosis of biliary stricture is essential in order to allow timely treatment with percutaneous or endoscopic intervention. Therefore, a high index of suspicion is required to ensure a proper diagnosis. The correct diagnosis may be difficult to determine based on imaging studies such as abdominal CT and ERCP, in the absence of a complete history. The condition may be mistaken for cholangiocarcinoma, if history of abdominal trauma is not available, and may result in unnecessary surgery. Most patients with a biliary stricture secondary to blunt abdominal trauma develop jaundice as the initial symptom. The hepatobiliary area was not entered during the surgery, thus reducing the possibility of an iatrogenic trauma. We believe that the suprapancreatic biliary stricture in our patient was caused by disruption of the blood supply and extrinsic compression by a hematoma. The possible mechanisms for the development of an intrapancreatic biliary stricture include the following: posttraumatic pancreatitis with swelling of the pancreatic head, and compression of the intrapancreatic portion of the CBD this usually resolves as the swelling of the pancreas subsides. The possible mechanisms underlying the development of a suprapancreatic biliary stricture are: (1) local inflammation followed by fibrosis and stricture formation secondary to ductal tear (2) disruption of the blood supply to the bile duct, and (3) compression of the biliary duct by an intramural or extrabiliary hematoma. The proposed mechanisms of extrahepatic biliary strictures after blunt trauma differ based on their location.

Gallbladder trauma due to car accident signs driver#

It is most commonly seen following motor vehicle accidents when an unrestrained driver has an impact with the steering wheel. Therefore, non iatrogenic bile duct injuries secondary to blunt abdominal trauma are extremely rare. The bile ducts are located deep within the abdomen and are protected by the ribs, liver and mesentery. Computer tomography (CT) scan of the abdomen revealed dilatation of both intrahepatic (IHD) and extrahepatic biliary ducts (EHD) with abrupt cut-off of the suprapancreatic portion of the common bile duct (CBD) (Figure 1). The amylase and lipase levels were within the normal range.

The initial liver function tests were as follows: aspartate aminotransferase 60 U/L (normal range, 0-37 U/L), alanine aminotransferase 92 U/L (normal range, 0-41 U/L), alkaline phosphatase 317 U/L (normal range, 35-130 U/L), gamma-glutamyl transferase 107 U/L (normal range, 8-61 U/L), total bilirubin 16.9 mg/dL (normal range, 0-1.2 mg/dL), and direct bilirubin 11.3 mg/dL (normal range, 0-0.3 mg/dL). Physical examination showed no abdominal pain, or tenderness to palpation. Two weeks after the accident, the patient developed jaundice and was transferred to our hospital for further evaluation and management.Īt admission, the patient had overt jaundice with itching over the entire body. Surgery was performed and the mesenteric tear was repaired. The patient was hospitalized for the treatment of hemoperitoneum caused by a mesenteric tear.

Gallbladder trauma due to car accident signs full#

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