Biliary stricture caused by blunt abdominal trauma: clinical and radiologic features in five patients.

PURPOSE

To evaluate the clinical and radiologic features of biliary stricture after blunt abdominal trauma and to report the results of endoscopic stent placement.

MATERIALS AND METHODS

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.

RESULTS

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.

CONCLUSION

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.