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Case Reports
. 2017 Oct-Dec;10(4):211-214.
doi: 10.4103/JETS.JETS_136_16.

Biliary Complications after Hepatic Trauma in Children

Riccardo Guanà  1 , Carbonaro Giulia  1 , Andrea Brunati  1 , Salvatore Garofalo  1 , Jurgen Schleef  1
Affiliations
Case Reports

Biliary Complications after Hepatic Trauma in Children

Riccardo Guanà et al. J Emerg Trauma Shock. 2017 Oct-Dec.

Abstract

Aim of the study: In pediatric patients with liver trauma and hemodynamic stability, conservative treatment is acknowledged as the gold standard.

Patients and methods: We conducted a retrospective analysis of 116 consecutive pediatric patients (<14-year-old) observed at our institution for closed abdominal trauma from January 2010 to January 2016. Among these, 16 patients (13%) had hepatic trauma Grade II or more, according to Moore liver trauma injury score.

Results: Only one patient underwent surgery for hemodynamic instability; all others children received conservative treatment according to the American Paediatric Surgical Association guidelines. Three patients had a biliary complication (2, 5%). two patients treated surgically by drainage insertion and one was managed conservatively.

Conclusions: Biliary complications of liver trauma in children may require aggressive surgical approach in selective patients.

Keywords: Biliary complication; children; hepatic trauma.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
(Case 1) Computed tomography-scan immediately after trauma with wide intrahepatic laceration involving SIV and SV; (a) 6-h after admission computed tomography-scan; (b) Cholangio- magnetic resonance imaging on day 5 showing laceration of an intrahepatic biliary duct; (c) 8 cm residual perihepatic collection on day 10 (d)
Figure 2
Figure 2
(Case 2) abdominal computed tomography-scan appearance immediately after the trauma; (a) abdominal computed tomography-scan after readmission, demonstrating blood in the gallbladder (b)
Figure 3
Figure 3
(Case 3) Moore IV hepatic laceration and splenic fracture (a-d)
See this image and copyright information in PMC

References

    1. Garvey EM, Haakinson DJ, McOmber M, Notrica DM. Role of ERCP in pediatric blunt abdominal trauma: A case series at a level one pediatric trauma center. J Pediatr Surg. 2015;50:335–8. - PubMed
    1. Zundel S, Lieber J, Tsiflikas I, Henk AK, Schmittenbecher P. Strategies for paediatric spleen and liver injuries. Zentralbl Chir. 2014;139:592–9. - PubMed
    1. Kulaylat AN, Stokes AL, Engbrecht BW, McIntyre JS, Rzucidlo SE, Cilley RE. Traumatic bile leaks from blunt liver injury in children: A multidisciplinary and minimally invasive approach to management. J Pediatr Surg. 2014;49:424–7. - PubMed
    1. Soukup ES, Russell KW, Metzger R, Scaife ER, Barnhart DC, Rollins MD. Treatment and outcome of traumatic biliary injuries in children. J Pediatr Surg. 2014;49:345–8. - PubMed
    1. Kapoor S, Nundy S. Bile duct leaks from the intrahepatic biliary tree: A review of its etiology, incidence, and management. HPB Surg. 2012;2012:752932. - PMC - PubMed

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