Zhang Shengming, He Yifeng, Zhou Daiwei, Jiang Jianhong, Wen Jianfan, Zeng Deqin
Guangdong Provincial Emergency Hospital, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou 510317, Guangdong, China.
ILIVER. 2025 Apr 4;4(2):100156. doi: 10.1016/j.iliver.2025.100156. eCollection 2025 Jun.
Closed trauma-induced extrahepatic bile duct injuries have been occasionally reported. However, isolated intrahepatic bile duct injuries are extremely rare due to the deep location of the intrahepatic bile ducts and the protection provided by surrounding vital blood vessels and organs. We report a case of a 50-year-old female who sustained an incomplete rupture of the left hepatic bile duct following a car accident. The patient was urgently transferred to a nearby hospital for treatment after the incident. On the 15th day of hospitalization, she developed abdominal distension, nausea, indigestion, and white stool. Large volumes of dark green ascitic fluid were drained via ultrasound-guided abdominal paracentesis. The patient requested further specialized diagnosis and treatment and was subsequently transferred to our hospital. Ultimately, percutaneous transhepatic cholangiography (PTC) revealed contrast agent extravasation from the left intrahepatic bile duct, confirming a traumatic bile duct injury. The patient underwent left hemihepatectomy on the 30th day post-injury and was discharged on the 12th postoperative day following a successful recovery.
闭合性创伤性肝外胆管损伤偶尔有报道。然而，由于肝内胆管位置较深以及周围重要血管和器官的保护，孤立性肝内胆管损伤极为罕见。我们报告一例50岁女性，在车祸后发生左肝内胆管不完全破裂。事件发生后，患者被紧急转至附近医院治疗。住院第15天，她出现腹胀、恶心、消化不良和白便。通过超声引导下腹腔穿刺引流大量深绿色腹水。患者要求进一步专科诊断和治疗，随后转至我院。最终，经皮肝穿刺胆管造影（PTC）显示造影剂从左肝内胆管外渗，证实存在创伤性胆管损伤。患者在受伤后第30天接受了左半肝切除术，术后恢复顺利，于术后第12天出院。
