Crushed Confluence with Significant Tissue Loss: A Case Report of a Rare Biliary Tract Injury following Blunt Trauma Abdomen

Abstract

Traumatic extrahepatic biliary tract injuries are rare occurrences because they are a relatively small target of injury following trauma. They are almost always associated with injuries to surrounding structures, which take precedence during initial management. The management of extrahepatic biliary tract injuries depends on the extent and level of the injury. This may include primary repair to high-level biliary-enteric anastomoses. We report a case of injury to the biliary confluence that occurred after blunt trauma abdomen. The injury was associated with an extensive liver injury that was the focus of initial treatment. We discuss the possible mechanisms that led to injury of this relatively hidden area and describe the various treatment options that can be applicable in such cases.

Keywords: biliary confluence injuries; biliary-enteric anastomoses; grade iv liver injury; polytrauma; road traffic accident; traumatic biliary tract injuries.