Yoon K H, Ha H K, Kim M H, Seo D W, Kim C G, Bang S W, Jeong Y K, Kim P N, Lee M G, Auh Y H
Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Radiology. 1998 Jun;207(3):737-41. doi: 10.1148/radiology.207.3.9609898.
To evaluate the clinical and radiologic features of biliary stricture after blunt abdominal trauma and to report the results of endoscopic stent placement.
Medical records and radiologic findings were reviewed in five patients with biliary stricture after blunt abdominal trauma. The level, length, and contour of the strictures were analyzed with endoscopic retrograde cholangiopancreatography (ERCP). Computed tomographic (CT) scans were also reviewed to determine the presence of biliary dilatation, configuration of the injured bile duct, and ancillary abdominal findings. Results from endoscopic stent placement were evaluated in all patients.
Stricture occurred in the suprapancreatic portion of the common bile duct in four patients and in the intrapancreatic portion in one patient. At ERCP, the stricture contour was concentric and smooth in three patients, eccentric and smooth in one, and abruptly terminated in one. CT showed abrupt narrowing of the common bile duct with dilatation of the proximal portion in all patients. Endoscopic stent placement was successful in all patients.
Patients with biliary stricture after blunt abdominal trauma exhibit a delayed onset of symptoms. A correct diagnosis may be difficult on the basis of findings from CT or ERCP alone without a clinical history or evidence of contusions at other sites.
评估钝性腹部创伤后胆管狭窄的临床和放射学特征，并报告内镜下支架置入的结果。
回顾了5例钝性腹部创伤后胆管狭窄患者的病历和放射学检查结果。通过内镜逆行胰胆管造影（ERCP）分析狭窄的部位、长度和形态。还回顾了计算机断层扫描（CT）结果，以确定是否存在胆管扩张、损伤胆管的形态以及腹部其他相关表现。评估了所有患者内镜下支架置入的结果。
4例患者的胆管狭窄发生在胆总管胰上段，1例发生在胰内段。在ERCP检查中，3例患者的狭窄形态为同心且光滑，1例为偏心且光滑，1例呈突然截断状。CT显示所有患者胆总管均有突然狭窄并伴有近端扩张。所有患者内镜下支架置入均成功。
钝性腹部创伤后胆管狭窄患者症状出现较晚。若无临床病史或其他部位挫伤的证据，仅根据CT或ERCP检查结果可能难以做出正确诊断。
