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Traumatic avulsion of the intrapancreatic common bile duct:
case report

Case report, 27 - 30
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English version

Injuries of the extra hepatic biliary tree following blunt trauma to the abdomen are rare.We present a case of avulsion of the intrapancreatic common bile duct.
Very often the lesion is not identifiable until the signs of jaundice and biliary ascites occur. Intraoperative cholangiography is mandatory for the diagnosis, but the noninvasive magnetic resonance cholangiopancreatography could readily depict the injury of the extrahepatic bile duct preoperatively. When the diagnosis is late the corner stone of treatment is biliary diversion and definitive repair after complete resolution of sepsis with a choledochojejunostomy.

Versione Italiana

Le lesioni dell?albero biliare extraepatico per trauma addominale chiuso sono rare. Presentiamo un caso di avulsione del coledoco intrapancreatico.
Molto spesso le lesione non è identificabile fino a quando non compaiono i segni di ittero e ascite biliare. La colangiografia intraoperatoria è fondamentale per la diagnosi, ma la meno invasiva colangio-RMN è efficace nell?individuare preoperatoriamente una lesione del coledoco. Quando la diagnosi è tardiva gli obiettivi del trattamento sono la diversione biliare e la riparazione definitiva con una coledocodigiunostomia dopo completa risoluzione della sepsi.

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