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J Acute Care Surg > Volume 11(3); 2021 > Article
Journal of Acute Care Surgery 2021;11(3):137-140.
DOI: https://doi.org/10.17479/jacs.2021.11.3.137    Published online November 23, 2021.
An Unusual Recurrent Bile Leak Following High Grade Liver Trauma
Morgan E Jones1  , Ee Jun Ban1,2  , Charles H. C. Pilgrim1,2 
1Alfred Health, Department of General Surgery, Melbourne, Victoria, Australia
2National Trauma Research Institute, Melbourne, Victoria, Australia
Correspondence:  Morgan E Jones,
Email: mor.jones@alfred.org.au
Received: 5 March 2021   • Revised: 2 July 2021   • Accepted: 28 July 2021
Abstract
Non-operative management of blunt liver injury has been demonstrated as a safe and effective treatment for most grades of injury. As the severity of liver injury increases, so does the risk of complications. A 21-year-old male was brought to the trauma center following a high speed motorbike accident. He underwent a laparotomy and angioembolization for a Grade 4 liver injury. A biloma was diagnosed on Day 18 post injury, and he underwent Endoscopic Retrograde Cholangiopancreatography and biliary stenting which were unsuccessful. There were 2 re-admissions for infected perihepatic collections. In this case, an Endoscopic Retrograde Cholangiopancreatography was not a helpful procedure due to a disconnected liver segment, and morbidity occurred due to instrumentation of the biliary tree (the likely cause of infected biloma). Hepatic resection should be considered for patients who fail non-operative management. Further assessment of efficacy using a larger dataset for analysis is required.
Key Words: bile, endoscopic retrograde cholangiopancreatography, laparotomy, liver, trauma, wounds
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