Bile duct injury complicated by bilioma after blunt liver trauma in a child

Area of Science:

• Pediatric Surgery
• Abdominal Trauma Management
• Biliary Tract Injury

Background:

• Nonoperative management is the standard for blunt liver injury, but biliary tract injuries can be associated complications.
• Posttraumatic extraductal biliary collections (biliomas) are rare, particularly in pediatric blunt abdominal trauma.
• Close observation is crucial for nonoperative management of blunt liver injuries.

Observation:

• A 5-year-old boy with blunt abdominal trauma developed a bilioma following liver laceration.
• The patient's liver injury was managed nonoperatively.
• Computed tomography (CT)-guided needle aspiration and percutaneous catheter drainage confirmed the bilioma and enabled nonoperative management.

Findings:

• The bilioma was successfully managed nonoperatively via percutaneous catheter drainage.
• The patient recovered fully, remaining symptom-free with normal liver function and ultrasound findings six months post-trauma.
• This case demonstrates the feasibility of nonoperative management for pediatric biliomas secondary to blunt liver trauma.

Implications:

• Nonoperative management of biliomas in children is a viable option with percutaneous drainage.
• Vigilance for potential bile duct injury is essential during prolonged observation of nonoperatively managed blunt liver trauma.
• Early diagnosis and intervention can lead to favorable outcomes in rare pediatric bilioma cases.