Spontaneous fistulisation of the common bile duct after transection by gunshot

2021 ◽  
Vol 14 (2) ◽  
pp. e238473
Author(s):  
Jessica Howard ◽  
Suzanne Di Sano ◽  
David Burnett
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
High Volume ◽  
Outpatient Setting ◽  
Surgical Reconstruction ◽  
Duodenal Wall ◽  
Haemodynamic Instability ◽  
Immediate Reconstruction ◽  
The Common ◽  
Duodenal Perforations

A 35-year-old man presented with a gunshot wound to his abdomen via his lower chest. Initial laparotomy did not identify any perforation or contamination. On day 3, a laparotomy under the hepatobiliary service discovered a gastric perforation, two lateral duodenal perforations and a complete transection of the common bile duct, presumably delayed perforation from the shockwave injury produced by the bullet. Contamination and haemodynamic instability precluded immediate reconstruction, and abdominal drains and external biliary drainage were established. High-volume duodenal fistula was managed with slow withdrawal of drains, and inadvertent dislodgement of the biliary drain in an outpatient setting resulted in spontaneous fistulisation of the bile duct to the lateral duodenal wall, with creation of a neo-bile duct. The patient remains well more than 1 year later, without external drainage despite no surgical reconstruction.

scholarly journals Duodenal peripapillary adenocarcinoma causing extrahepatic biliary obstruction and icterus in a cat

2020 ◽  
Vol 89 (5) ◽  
pp. 273-277
Author(s):  
T. Rick ◽  
E. Stock ◽  
I. Van de Maele ◽  
E. Kammergruber ◽  
J. Saunders
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Biliary Obstruction ◽  
Ultrasound Examination ◽  
Duodenal Wall ◽  
Abdominal Ultrasonography ◽  
Extrahepatic Biliary Obstruction ◽  
History Of ◽  
The Common ◽  
Distal Aspect

A six-year-old, female, neutered domestic shorthair cat was presented with chronic weight loss and a two-day history of partial anorexia and lethargy. Abdominal ultrasonography revealed a regional thickening of the duodenal wall with loss of normal layering, a normally walled segmentally dilated distal aspect of the common bile duct containing slightly hyperechoic bile, and a mild to moderately enlarged major duodenal papilla. Based on the ultrasound examination, the primary differential diagnosis was a peripapillary duodenal neoplastic or less likely, an inflammatory or infectious process with secondary extrahepatic biliary obstruction. Postmortem examination revealed a duodenal, peripapillary adenocarcinoma with metastasis into the liver and lymph nodes, and external compressive obstruction of cystic- and common bile duct.

scholarly journals Structure and Innervation of the Extrahepatic Biliary System in the Australian Possum, Trichosurus Vulpecula

HPB Surgery ◽  
1993 ◽  
Vol 7 (2) ◽  
pp. 125-140 ◽  
Author(s):  
R. T. A. Padbury ◽  
R. A. Baker ◽  
J. P. Messenger ◽  
J. Toouli ◽  
J. B. Furness
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Bile Ducts ◽  
Internal Sphincter ◽  
External Sphincter ◽  
Duodenal Wall ◽  
Sphincter Muscle ◽  
Trichosurus Vulpecula ◽  
Nerve Fibres ◽  
The Common

The morphology, microanatomy and innervation of the biliary tree of the Australian possum, Trichosurus vulpecula, was examined. The gross morphology of the gallbladder, hepatic and cystic ducts, and the course of the common bile duct, conforms to those of other species. The sphincter of Oddi has an extraduodenal segment that extends 15mm from the duodenal wall; within this segment the pancreatic and common bile ducts are ensheathed together by sphincter muscle. Their lumens unite to form a common channel within the terminal intraduodenal segment.Nerve cell bodies of the gallbladder were found in an inter-connecting network of ganglia that were located in the serosa, muscularis and mucosa. Nerve fibres innervated the muscle, arterioles and the mucosa. Few ganglia were found along the supra sphincteric portion of the common bile duct. Nerve trunks followed the duct and a dense nerve fibre plexus was found in the mucosa. In the sphincter most ganglia were located in two plexuses, the first between the layers of the external sphincter muscle, which was continuous with the external muscle of the duodenum, and the second was associated with the internal sphincter muscle. Nerve fibres were numerous in the sphincter muscle, and were also found in the subepithelial and periglandular plexuses of both the pancreatic and common bile ducts.

scholarly journals Observational Study of Variations in Termination of the Common Bile Duct in Human Cadaver

2015 ◽  
Vol 12 (1) ◽  
pp. 11-13
Author(s):  
Laila Farzana Khan ◽  
Humaira Naushaba ◽  
Jubaida Gulshan Ara
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Pancreatic Duct ◽  
Main Pancreatic Duct ◽  
Distal Portion ◽  
Duodenal Wall ◽  
Common Channel ◽  
Cross Sectional ◽  
Medical College ◽  
The Common

Context: The union of the distal portion of the common bile duct and the main pancreatic duct varies. They together may form short common channel or long common channel or may open separately into the second part of the duodenum. So detailed anatomical knowledge is essential for any surgical or endoscopic treatment of this region. Materials and Methods: A cross sectional descriptive type of study was carried out in the department of Anatomy, Sir Salimullah Medical College on sixty two (62) human cadaveric extra hepatic biliary apparatus with pancreatic duct. The samples were collected from unclaimed dead bodies that were under examination in the department of Forensic Medicine of Dhaka Medical College, Dhaka and Sir Salimullah Medical College, Dhaka. The present study was conducted to observe the variations in termination of common bile duct with main pancreatic duct in human cadavers. Results: The common bile duct was found to unite with main pancreatic duct within the duodenal wall in 61.3% cases and outside the duodenal wall in 38.7% cases. Conclusion: The findings of the present study revealed that the termination of the common bile duct varies from individual to individual. DOI: http://dx.doi.org/10.3329/bja.v12i1.22611 Bangladesh Journal of Anatomy, January 2014, Vol. 12 No. 1 pp 11-13

Cholangioscopy using the SpyGlass System for a Rare Cause of Obstruction: Inflammatory Polyp of the Common Bile Duct

2017 ◽  
Vol 26 (2) ◽  
pp. 111 ◽  
Author(s):  
Theodor Voiosu ◽  
Monica Ionita ◽  
Andrei Voiosu ◽  
Andreea Bengus ◽  
Cristiana Popp ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Inflammatory Polyp ◽  
The Common

.

Milk of Calcium in the Common Bile Duct: CT Identification

2002 ◽  
Vol 179 (3) ◽  
pp. 804-805 ◽  
Author(s):  
Joseph P. Mazzie ◽  
Burton M. Gold ◽  
Robert Bartolomeo ◽  
Douglas S. Katz
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Milk Of Calcium ◽  
The Common

scholarly journals Endoscopic Fistulotomy – ‘The Suprapapillary Punch’: A Method of Access to the Bile Duct during ERCP

1994 ◽  
Vol 8 (1) ◽  
pp. 33-35
Author(s):  
Noel B Hershfield
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Biliary Tree ◽  
Usual Method ◽  
Endoscopic Retrograde ◽  
The Common ◽  
A Minor ◽  
Endoscopic Fistulotomy

Endoscopic retrograde cholangiopancreatography (ERCP) is established as the method of choice to investigate the biliary tree when obstruction is suspected. On rare occasions, the papilla cannot be entered because of anatomical or pathological abnormalities. This report describes endoscopic fistulotomy or the suprapapillary punch that has been carried out at the Foothills Hospital in Calgary, Alberta, on 30 of 623 patients referred for ERCP for conditions causing obstruction of the common bile duct or suspected obstruction of the common bile duct. The following communication also describes the method of suprapapillary punch or endoscopic fistulotomy. Results have been excellent with only one complication, a minor attack of pancreatitis after the procedure. In summary, the suprapapillary punch or fistulotomy is a safe and useful method for entering the common bile duct when access by the usual method is impossible.

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