The case of the disappearing bullet: An extraluminal compression of the biliary tree

Trauma ◽  
2021 ◽  
pp. 146040862110009
Author(s):  
M Mihalik ◽  
N Allopi

Penetrating abdominal injuries, especially from gun shot wounds, are a common occurrence in South African hospitals, and a vast majority of these patient receive surgical intervention for suspected intra-abdominal injuries. Not all bullets are found and removed however, and we detail the case of a gentleman who presented to our institution with obstructive jaundice secondary to an extraluminal compression of his biliary tree by a retained migrated bullet, that spontaneously resolved, without any surgical intervention.

2017 ◽  
Vol 10 ◽  
pp. 117955221771143 ◽  
Author(s):  
Catherine Linzay ◽  
Abhishek Seth ◽  
Kunal Suryawala ◽  
Ankur Sheth ◽  
Moheb Boktor ◽  
...  

Background: Hepatic artery aneurysms (HAAs) constitute 14% to 20% of visceral artery aneurysms. Most HAAs are asymptomatic. Although rare, obstructive jaundice due to external bile duct compression or rupture of the HAA into the biliary tree with occlusion of the lumen from blood clots has been reported. Case presentation: A 56-year-old white man presented to an outside hospital with symptoms of obstructive jaundice, including abdominal pain and yellowing of the skin. Imaging showed a large HAA. Patient was transferred to our hospital where an endoscopic retrograde cholangiopancreatography with biliary stenting was performed. This was followed by coil embolization of the HAA with improvement in symptoms and liver chemistries. Conclusions: Most clinicians agree that management of HAA is highly variable and depends on clinical presentation and anatomic location. Biliary stenting provides temporary relief for patients with obstructive jaundice. Definitive options include open aneurysmal repair versus endovascular therapy. Hepatic artery aneurysms represent a significant risk for hemorrhage and therefore must be addressed promptly once discovered.


2021 ◽  
pp. 20-24
Author(s):  
Zaipula Zulbegovich Nazhmudinov ◽  
Abdulkamal Guseynovich Guseynov

The paper presents a case of successful surgical treatment of a patient with common bile duct ascariasis, which caused obstructive jaundice. Modern methods of examining a patient with obstructive jaundice did not allow to make the right diagnosis of the common bile duct ascariasis before surgical intervention. The rarity of this pathology arouses interest in this material.


2012 ◽  
Vol 35 (6) ◽  
pp. 351 ◽  
Author(s):  
Nurettin Kahramansoy ◽  
Hayri Erkol ◽  
Edip E Yilmaz ◽  
Mustafa Şit ◽  
Fahri Yilmaz ◽  
...  

Purpose: Reversible obstructive jaundice models have some limiting features, including the need for a second anaesthesia, re-laparotomy and surgical intervention after common bile duct ligation. The present study investigates the feasibility of a new application that can eliminate these limitations. Rapidly absorbable suture materials were used for ligation; therefore, spontaneous biliary decompression was anticipated by the self release of these rapidly degrading materials. Methods: Common bile ducts in Wistar Albino rats were ligated with silk, polyglytone 6211, or irradiated polyglactine 910 (n=7 for each group). Rats were grouped according to both the suture materials and the experiments termination date: 5 days (sham, silk5, polyglytone5, polyglactine5) and 21 days (silk21, polyglytone21, polyglactine21) after the ligation. Biochemical and morphologic changes of liver were assessed. Results: The group polyglactine21 showed significantly lower mean ALT, AST, GGT, total and direct bilirubin values when compared with the group polyglactine5 (p=0.004-0.037). Morphologic changes did not correlate with the biochemical amelioration. In the group polyglytone21, not only the biochemical but also the morphologic changes significantly ameliorated when compared with the group polyglytone5 (p=0.003-0.043). No procedure associated mortality was observed. Conclusion: Common bile duct ligation with polyglytone offers a new reversible model for prolonged obstructive jaundice which abolishes the need for relaparotomy and a second surgical intervention and significantly reduces mortality.


2020 ◽  
Vol 79 ◽  
pp. 300-304 ◽  
Author(s):  
Amee D. Azad ◽  
Victor Y. Kong ◽  
Damian L. Clarke ◽  
Grant L. Laing ◽  
John L. Bruce ◽  
...  

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