Kim P C, Gilas T, Brulé M F
Department of Surgery, Toronto East General & Orthopaedic Hospital Inc., University of Toronto, Ont.
Can J Surg. 1993 Dec;36(6):533-6.
Isolated injury to the extrahepatic biliary tree after blunt trauma is rare. The authors describe the case of a 17-year-old boy who suffered such an injury after falling over the handlebar of his motorcycle. Ultrasonography, computed tomography and abdominal paracentesis were used to make the diagnosis. At laparotomy there was a partial tear of the common bile duct at its junction with the cystic duct. A cholecystectomy was performed and a T tube inserted. The patient recovered without complication. The authors emphasize that only awareness of the condition and diagnostic confirmation by computed tomography and abdominal paracentesis can expedite the diagnosis and treatment. The choice of surgical repair must be individualized according to the clinical findings and the nature of the injury.
钝性创伤后肝外胆管树的孤立性损伤很少见。作者描述了一名17岁男孩的病例,他在骑摩托车时从车把上摔下后遭受了这种损伤。通过超声、计算机断层扫描和腹腔穿刺术进行诊断。剖腹手术时发现胆总管在与胆囊管交界处有部分撕裂。进行了胆囊切除术并插入了T管。患者康复且无并发症。作者强调,只有认识到这种情况并通过计算机断层扫描和腹腔穿刺术进行诊断确认,才能加快诊断和治疗。手术修复的选择必须根据临床发现和损伤的性质进行个体化。