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Biliary Trauma
Siva P. Raman, MD
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KEY FACTS

  • Imaging

    • Clinical Issues

      TERMINOLOGY

      • Synonyms

        • Bile duct injury
      • Definitions

        • Hemobilia: Bleeding into biliary tract
        • Bilhemia: Rare condition in which bile enters veins of liver

      IMAGING

      • General Features

        • Radiographic Findings

          • Fluoroscopic Findings

            • CT Findings

              • MR Findings

                • Ultrasonographic Findings

                  • Angiographic Findings

                    • Nuclear Medicine Findings

                      • Other Modality Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Staging, Grading, & Classification

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Consider

                                              Selected References

                                              1. Emara MH et al: Postcholecystectomy biliary injuries: frequency, and role of early versus late endoscopic retrograde cholangiopancreatography. Eur J Gastroenterol Hepatol. 33(5):662-9, 2021
                                              2. Oo J et al: Management of bile leak following blunt liver injury: a proposed guideline. ANZ J Surg. ePub, 2021
                                              3. Reddy S et al: MRI evaluation of bile duct injuries and other post-cholecystectomy complications. Abdom Radiol (NY). ePub, 2021
                                              4. Streith L et al: Optimal treatments for hepato-pancreato-biliary trauma in severely injured patients: a narrative scoping review. Can J Surg. 63(5):E431-4, 2020
                                              5. Hommes M et al: Management of biliary complications in 412 patients with liver injuries. J Trauma Acute Care Surg. 77(3):448-51, 2014
                                              6. Mbarushimana S et al: CT diagnosis of an iatrogenic bile duct injury. BMJ Case Rep. 2014, 2014
                                              7. Melamud K et al: Biliary imaging: multimodality approach to imaging of biliary injuries and their complications. Radiographics. 34(3):613-23, 2014
                                              8. Stewart L: Iatrogenic biliary injuries: identification, classification, and management. Surg Clin North Am. 94(2):297-310, 2014
                                              9. Mercado MA et al: Classification and management of bile duct injuries. World J Gastrointest Surg. 3(4):43-8, 2011
                                              10. Shah PA et al: Hepatic gas: widening spectrum of causes detected at CT and US in the interventional era. Radiographics. 31(5):1403-13, 2011
                                              11. Chin MW et al: Hemobilia. Curr Gastroenterol Rep. 12(2):121-9, 2010
                                              12. Pawa S et al: ERCP in the management of biliary complications after cholecystectomy. Curr Gastroenterol Rep. 11(2):160-6, 2009
                                              13. Hoeffel C et al: Normal and pathologic features of the postoperative biliary tract at 3D MR cholangiopancreatography and MR imaging. Radiographics. 26(6):1603-20, 2006
                                              14. Familiari L et al: An endoscopic approach to the management of surgical bile duct injuries: nine years' experience. Dig Liver Dis. 35(7):493-7, 2003
                                              15. Federle MP et al: Complications of liver transplantation: imaging and intervention. Radiol Clin North Am. 41(6):1289-305, 2003
                                              16. Goffette PP et al: Traumatic injuries: imaging and intervention in post-traumatic complications (delayed intervention). Eur Radiol. 12(5):994-1021, 2002
                                              17. Wong YC et al: Magnetic resonance imaging of extrahepatic bile duct disruption. Eur Radiol. 12(10):2488-90, 2002
                                              18. Green MH et al: Haemobilia. Br J Surg. 88(6):773-86, 2001
                                              19. Yoon KH et al: Biliary stricture caused by blunt abdominal trauma: clinical and radiologic features in five patients. Radiology. 207(3):737-41, 1998
                                              20. Slanetz PJ et al: Imaging and interventional radiology in laparoscopic injuries to the gallbladder and biliary system. Radiology. 201(3):595-603, 1996
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Imaging

                                                • Clinical Issues

                                                  TERMINOLOGY

                                                  • Synonyms

                                                    • Bile duct injury
                                                  • Definitions

                                                    • Hemobilia: Bleeding into biliary tract
                                                    • Bilhemia: Rare condition in which bile enters veins of liver

                                                  IMAGING

                                                  • General Features

                                                    • Radiographic Findings

                                                      • Fluoroscopic Findings

                                                        • CT Findings

                                                          • MR Findings

                                                            • Ultrasonographic Findings

                                                              • Angiographic Findings

                                                                • Nuclear Medicine Findings

                                                                  • Other Modality Findings

                                                                    • Imaging Recommendations

                                                                      DIFFERENTIAL DIAGNOSIS

                                                                        PATHOLOGY

                                                                        • General Features

                                                                          • Staging, Grading, & Classification

                                                                            • Gross Pathologic & Surgical Features

                                                                              • Microscopic Features

                                                                                CLINICAL ISSUES

                                                                                • Presentation

                                                                                  • Demographics

                                                                                    • Natural History & Prognosis

                                                                                      • Treatment

                                                                                        DIAGNOSTIC CHECKLIST

                                                                                        • Consider

                                                                                          Selected References

                                                                                          1. Emara MH et al: Postcholecystectomy biliary injuries: frequency, and role of early versus late endoscopic retrograde cholangiopancreatography. Eur J Gastroenterol Hepatol. 33(5):662-9, 2021
                                                                                          2. Oo J et al: Management of bile leak following blunt liver injury: a proposed guideline. ANZ J Surg. ePub, 2021
                                                                                          3. Reddy S et al: MRI evaluation of bile duct injuries and other post-cholecystectomy complications. Abdom Radiol (NY). ePub, 2021
                                                                                          4. Streith L et al: Optimal treatments for hepato-pancreato-biliary trauma in severely injured patients: a narrative scoping review. Can J Surg. 63(5):E431-4, 2020
                                                                                          5. Hommes M et al: Management of biliary complications in 412 patients with liver injuries. J Trauma Acute Care Surg. 77(3):448-51, 2014
                                                                                          6. Mbarushimana S et al: CT diagnosis of an iatrogenic bile duct injury. BMJ Case Rep. 2014, 2014
                                                                                          7. Melamud K et al: Biliary imaging: multimodality approach to imaging of biliary injuries and their complications. Radiographics. 34(3):613-23, 2014
                                                                                          8. Stewart L: Iatrogenic biliary injuries: identification, classification, and management. Surg Clin North Am. 94(2):297-310, 2014
                                                                                          9. Mercado MA et al: Classification and management of bile duct injuries. World J Gastrointest Surg. 3(4):43-8, 2011
                                                                                          10. Shah PA et al: Hepatic gas: widening spectrum of causes detected at CT and US in the interventional era. Radiographics. 31(5):1403-13, 2011
                                                                                          11. Chin MW et al: Hemobilia. Curr Gastroenterol Rep. 12(2):121-9, 2010
                                                                                          12. Pawa S et al: ERCP in the management of biliary complications after cholecystectomy. Curr Gastroenterol Rep. 11(2):160-6, 2009
                                                                                          13. Hoeffel C et al: Normal and pathologic features of the postoperative biliary tract at 3D MR cholangiopancreatography and MR imaging. Radiographics. 26(6):1603-20, 2006
                                                                                          14. Familiari L et al: An endoscopic approach to the management of surgical bile duct injuries: nine years' experience. Dig Liver Dis. 35(7):493-7, 2003
                                                                                          15. Federle MP et al: Complications of liver transplantation: imaging and intervention. Radiol Clin North Am. 41(6):1289-305, 2003
                                                                                          16. Goffette PP et al: Traumatic injuries: imaging and intervention in post-traumatic complications (delayed intervention). Eur Radiol. 12(5):994-1021, 2002
                                                                                          17. Wong YC et al: Magnetic resonance imaging of extrahepatic bile duct disruption. Eur Radiol. 12(10):2488-90, 2002
                                                                                          18. Green MH et al: Haemobilia. Br J Surg. 88(6):773-86, 2001
                                                                                          19. Yoon KH et al: Biliary stricture caused by blunt abdominal trauma: clinical and radiologic features in five patients. Radiology. 207(3):737-41, 1998
                                                                                          20. Slanetz PJ et al: Imaging and interventional radiology in laparoscopic injuries to the gallbladder and biliary system. Radiology. 201(3):595-603, 1996