Spontaneous fistulisation of the common bile duct after transection by gunshot
| Autor: | Suzanne Di Sano, David Burnett, Jessica Howard |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male 0301 basic medicine medicine.medical_specialty Duodenum medicine.medical_treatment Perforation (oil well) Case Report Abdominal Injuries 030105 genetics & heredity 03 medical and health sciences 0302 clinical medicine Laparotomy Intestinal Fistula medicine Humans Duodenal Perforation Common Bile Duct Common bile duct Bile duct business.industry General Medicine medicine.disease Surgery medicine.anatomical_structure Duodenal Fistula Drainage Abdomen Wounds Gunshot Gunshot wound Tomography X-Ray Computed business 030217 neurology & neurosurgery |
| Zdroj: | BMJ Case Rep |
| ISSN: | 1757-790X |
| DOI: | 10.1136/bcr-2020-238473 |
| Popis: | A 35-year-old man presented with a gunshot wound to his abdomen via his lower chest. Initial laparotomy did not identify any perforation or contamination. On day 3, a laparotomy under the hepatobiliary service discovered a gastric perforation, two lateral duodenal perforations and a complete transection of the common bile duct, presumably delayed perforation from the shockwave injury produced by the bullet. Contamination and haemodynamic instability precluded immediate reconstruction, and abdominal drains and external biliary drainage were established. High-volume duodenal fistula was managed with slow withdrawal of drains, and inadvertent dislodgement of the biliary drain in an outpatient setting resulted in spontaneous fistulisation of the bile duct to the lateral duodenal wall, with creation of a neo-bile duct. The patient remains well more than 1 year later, without external drainage despite no surgical reconstruction. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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