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bile leak trauma

Arpad Ivanecz, Vid Pivec, Bojan Ilijevec, Saša Rudolf, Stojan Potrč
BACKGROUND: Various minimally invasive therapies are important adjuncts to management of hepatic injuries. However, there is a certain subset of patients who will benefit from liver resection, but there are no reports in the literature on laparoscopic anatomical liver resection for the management of complications after blunt liver trauma. CASE PRESENTATION: A 20-year-old male was admitted to the Emergency Unit of a tertiary referral center following a car accident...
March 23, 2018: Surgical Case Reports
Charu Tiwari, Hemanshi Shah, Mukta Waghmare, Kiran Khedkar, Pankaj Dwivedi
Posttraumatic major bile leak in children is uncommon, with few cases reported in the literature. These injuries are seen in high-grade liver trauma and are difficult to diagnose and manage. We describe a 7-year-old boy with grade IV hepatic trauma and bile leak following blunt abdominal trauma. The leak was successfully managed by percutaneous drainage and endoscopic retrograde cholangiopancreatography (ERCP) stenting of the injured hepatic duct. How to cite this article: Tiwari C, Shah H, Waghmare M, Khedkar K, Dwivedi P...
July 2017: Euroasian journal of hepato-gastroenterology
Megan C Prunty, Siddharth Kudav, Jacob A Quick
BACKGROUND: Traumatic thoracoabdominal injuries can involve multiple organs and multiple cavities, which increases the complexity of surgical management. Traditionally, these injuries required laparotomy and thoracotomy. However, minimally invasive intervention may be reasonable for stable patients. MATERIALS AND METHODS: We present a case of a thoracoabdominal gunshot wound resulting in multiorgan, multicavity injury to the lung, diaphragm, and liver. We performed hepatorrhaphy and diaphragm repair, and addressed a retained hemothorax through a transabdominal laparoscopic approach...
November 21, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Tomohide Koyama, Jorunn Skattum, Peder Engelsen, Torsten Eken, Christine Gaarder, Pål Aksel Naess
BACKGROUND: Although nonoperative management (NOM) has become standard care, optimal treatment of liver injuries in children is still challenging since many of these patients have multiple injuries. Moreover, the role of angiography remains poorly defined, and a high index of suspicion of complications is warranted. This study reviews treatment and outcomes in children with liver injuries at a major Scandinavian trauma centre over a 12-year period. METHODS: Patients <17 years old with liver injury admitted to Oslo University Hospital Ullevaal during the period 2002-2013 were retrospectively reviewed...
November 29, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Parul Mohan, Harsh Mahajan
No abstract text is available yet for this article.
October 2016: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
Douglas G Adler, Georgios I Papachristou, Linda Jo Taylor, Tyler McVay, Madeleine Birch, Gloria Francis, Andrew Zabolotsky, Sobia N Laique, Umar Hayat, Tingting Zhan, Rohit Das, Adam Slivka, Mordechai Rabinovitz, Satish Munigala, Ali A Siddiqui
BACKGROUND AND AIMS: Postsurgical or traumatic bile duct leaks (BDLs) can be safely and effectively managed by endoscopic therapy via ERCP. The early diagnosis of BDL is important because unrecognized leaks can lead to serious adverse events (AEs). Our aim was to evaluate the relationship between timing of endotherapy after BDL and the clinical outcomes, AEs, and long-term results of endoscopic therapy. METHODS: We conducted a multicenter, retrospective study on patients with BDLs who underwent ERCP between 2006 and 2014...
April 2017: Gastrointestinal Endoscopy
Christina A LeBedis, David D B Bates, Jorge A Soto
Iatrogenic and traumatic bile leaks are uncommon. However, given the overall increase in number of hepatobiliary surgeries and the paradigm shift toward nonoperative management of patients with liver trauma, they have become more prevalent in recent years. Imaging is essential to establishing early diagnosis and guiding treatment as the clinical signs and symptoms of bile leaks are nonspecific, and a delay in recognition of bile leaks portends a high morbidity and mortality rate. Findings suspicious for a bile leak at computed tomography or ultrasonography include free or contained peri- or intrahepatic low density fluid in the setting of recent trauma or hepatobiliary surgery...
January 2017: Abdominal Radiology
David D B Bates, Christina A LeBedis, Jorge A Soto, Avneesh Gupta
This article presents the magnetic resonance protocols, imaging features, diagnostic criteria, and complications of commonly encountered emergencies in pancreaticobiliary imaging. Pancreatic trauma, bile leak, acute cholecystitis, biliary obstruction, and pancreatitis are discussed. Various classifications and complications that can arise with these conditions, as well as artifacts that may mimic pathology, are also included.
May 2016: Magnetic Resonance Imaging Clinics of North America
Charles de Mestral, Tarek Razek, Kosar Khwaja, Paola Fata
BACKGROUND: Extrahepatic biliary tract injuries following blunt abdominal trauma are very rare and pose a diagnostic and therapeutic challenge. CASE REPORT: We report a case of blunt liver injury with left extrahepatic duct transection following a motor vehicle collision. Technetium 99m dimethyliminodiacetic acid scan confirmed a bile leak and endoscopic retrograde cholangiopancreatography (ERCP) diagnosed the injury of the left extrahepatic duct. Management was initially conservative, consisting of external drainage along with trials of stent placement...
December 2008: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Qian Zhan, Xiaxing Deng, Yuanchi Weng, Jiabin Jin, Zhichong Wu, Hongwei Li, Baiyong Shen, Chenghong Peng
BACKGROUND: To explore the effectiveness, safety, and efficacy of the robot-assisted surgery in the radical resection of pancreatic ductal adenocarcinoma (PDAC). METHODS: The clinical data of 72 patients with PDAC who underwent radical resection using the da Vinci Surgical System from April 2010 to December 2014 were retrospectively analyzed. RESULTS: Among these 72 patients, three were converted to conventional laparotomy due to the vascular invasion or due to the difficulties in tissue isolation from the surrounding organs...
December 2015: Chinese Journal of Cancer Research, Chung-kuo Yen Cheng Yen Chiu
Christopher S Green, Eileen M Bulger, Sharon W Kwan
BACKGROUND: The liver is one of the most frequently injured abdominal organs. Hepatic hemorrhage is a complex and challenging complication following hepatic trauma. Significant shifts in the treatment of hepatic hemorrhage, including the increasing use of angioembolization, are believed to have improved patient outcomes. We aimed to describe the efficacy of angioembolization in the setting of acute hepatic arterial hemorrhage as well as the complications associated with this treatment modality...
March 2016: Journal of Trauma and Acute Care Surgery
Ammar Al-Hassani, Gaby Jabbour, Mohammad ElLabib, Ahad Kanbar, Ayman El-Menyar, Hassan Al-Thani
INTRODUCTION: Delayed bile leak following blunt liver trauma is not common. PRESENTATION OF CASE: We presented a case report and literature review of delayed bile leak in a young male patient who presented with grade IV blunt liver injury following a motor vehicle collision; he was a restrained driver who hit a fixed object. Physical examination was unremarkable except for revelaed tachycardia, right upper quadrant abdominal tenderness, and open left knee fracture...
2015: International Journal of Surgery Case Reports
Victoria Brown, Jennifer Martin, Damian Magee
Laparoscopic cholecystectomy is a commonly performed surgical procedure for the treatment of symptomatic cholelithiasis. As with all surgical procedures, it carries risk, with the most commonly reported complications including infection, bile leak and bleeding. One unusual complication is subcapsular liver haematoma, the diagnosis presented here. This is a rare occurrence; only a small number of cases have been reported in the literature and as yet no conclusive cause or management plan has been found. Iatrogenic liver trauma, the use of oral and intravenous non-steroidal anti-inflammatory drugs (NSAIDs) and anticoagulants have all been named as possible contributing factors...
June 25, 2015: BMJ Case Reports
Sana Naeem, Hanna Li, Zhiyun Yang
Hepatobiliary scintigraphy (HBS) is a widely used modality to diagnose biliary injury. In patients with a history of trauma or surgery, the common presentations of bile leaks on HBS are a progressive collection of radiotracer outside the biliary system. However, the precise localization of a bile leak is usually not conveyed by noninvasive techniques including CT or ultrasound or even HBS. This case study of a patient with liver trauma demonstrates a direct bile leak sign leading to recognition of an exact bile leakage site from the left intrahepatic duct...
March 2016: Journal of Nuclear Medicine Technology
N Guglielmo, F Melandro, L Improta, G Mennini, D Rossi, M Assenza, M Rossi, P B Berloco
Liver is frequently involved and injured in blunt abdominal trauma. Although over the last three decades the management of blunt hepatic trauma has gradually shifted toward nonoperative approach whit a significant reduction in overall mortality, surgery remains the main option for hemodinamically unstable patients whit severe liver injuries. A 16-yr-old male in good health suffered a blunt abdominal trauma from a sport accident falling while playing football resulting in a grade V liver injury according to the American Association for the Surgery of Trauma Organ Injury Score...
2015: La Clinica Terapeutica
Anita Balakrishnan, Reyad Abbadi, Kathryn Oakland, Saurabh Jamdar, Simon Jf Harper, Neville V Jamieson, Emmanual L Huguet, Asif Jah, Raaj K Praseedom
BACKGROUND: Equestrian sports are common outdoor activities that may carry a risk of liver injury. Due to the relative infrequency of equestrian accidents the injury patterns and outcomes associated with liver trauma in these patients have not been well characterized. METHODS: We examined our experience of the management of equestrian liver trauma in our regional hepatopancreaticobiliary unit at a tertiary referral center. The medical records of patients who sustained liver trauma secondary to equestrian activities were analysed for parameters such as demographic data, liver function tests, patterns of injury, radiological findings, the need for intervention and outcomes...
2014: Journal of Trauma Management & Outcomes
Martijn Hommes, Andrew J Nicol, Pradeep H Navsaria, Eline Reinders Folmer, Sorin Edu, Jake E J Krige
BACKGROUND: Bile leaks occur in 4% to 23% of patients after major liver injuries. The role of conservative management versus internal biliary drainage has not been clearly defined. The safety and efficacy of nonoperative management of bile leaks were studied. METHODS: Four hundred twelve patients with liver injuries were assessed in a prospective study between 2008 and 2013. All patients with clinically significant injuries to the intrahepatic biliary tract were evaluated...
September 2014: Journal of Trauma and Acute Care Surgery
Christina A LeBedis, Stephan W Anderson, Gustavo Mercier, Steven Kussman, Stephanie L Coleman, Louis Golden, David R Penn, Jennifer W Uyeda, Jorge A Soto
The purpose of this study was to determine the efficacy of CT to predict the development of bile leaks in hepatic trauma. This HIPAA-compliant retrospective study was IRB approved and consent was waived. All patients who sustained hepatic trauma between January 1, 2006, and January 31, 2012, and who underwent CT and hepatobiliary scans during the same hospital admission were included. One hundred and thirty-two patients met the inclusion criteria. Comparison between the presence of biliary injury relative to American Association for the Surgery of Trauma (AAST) hepatic injury grade and mean distance of the hepatic laceration to the inferior vena cava (IVC) was made...
April 2015: Emergency Radiology
Kira Melamud, Christina A LeBedis, Stephan W Anderson, Jorge A Soto
Although traumatic and iatrogenic bile leaks are rare, they have become more prevalent in recent years due to an increased propensity toward nonsurgical management of patients with liver trauma and an overall increase in the number of hepatobiliary surgeries being performed. Because clinical signs and symptoms of bile leaks are nonspecific and delay in the recognition of bile leaks is associated with high morbidity and mortality rates, imaging is crucial for establishing an early diagnosis and guiding the treatment algorithm...
May 2014: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Kuo-Ching Yuan, Yon-Cheong Wong, Chih-Yuan Fu, Chee-Jen Chang, Shih-Ching Kang, Yu-Pao Hsu
BACKGROUND: Major bile leak after blunt liver trauma is rare but challenging. It usually requires endoscopic retrograde cholangiography (ERC) for management. However, there is still lack of specific indications. The aim of this study is to elucidate risk factors for major bile leak and indications for early ERC after blunt liver trauma. METHODS: The trauma registry of a level I trauma center in Taiwan was queried, and all blunt liver trauma patients from June, 2008 to June, 2011 were selected for retrospective review...
2014: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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