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Case Reports
. 2014 Sep 29:2014:bcr2014204918.
doi: 10.1136/bcr-2014-204918.

CT diagnosis of an iatrogenic bile duct injury

Simon Mbarushimana  1 , Gareth Morris-Stiff  2 , Ahmed Hassn  3
Affiliations
Case Reports

CT diagnosis of an iatrogenic bile duct injury

Simon Mbarushimana et al. BMJ Case Rep. .

Abstract

Bile duct injuries are a recognised complication of cholecystectomy and a number of options exist for their evaluation. A 44-year-old woman presented with a suspected biliary leak 11 days following an open cholecystectomy. Her medical history was significant for biliopancreatic diversion 2 years previously. An ultrasound scan demonstrated a perihepatic collection but no dilation of the biliary tree was observed. The patient's surgical history and the lack of biliary dilation precluded an endoscopic retrograde cholangiopancreatography or percutaneous transhepatic cholangiography, and she could not undergo an MR cholangiopancreatography due to claustrophobia. A CT cholangiogram was performed and clarified the location of the injury, facilitating operative identification and repair of the bile duct. CT cholangiography performed as a dynamic procedure is useful as a means of identifying bile duct injuries.

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Figures

Figure 1
Figure 1
CT cholangiogram demonstrating a leak from the lateral wall of the common duct (broken arrow), with a large biloma extending laterally up to the subphrenic space also clearly identified (white arrows).
Figure 2
Figure 2
Strasberg classification of bile duct injuries.
See this image and copyright information in PMC

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