Traumatic rupture of the hepatic duct demonstrated by endoscopic retrograde cholangiography

Persistent jaundice and abdominal distention were noted postoperatively in a 37-year-old white male who had undergone splenectomy and suture of a liver laceration following a motorcycle accident. Abdominal paracentesis yielded bile-stained fluid. Endoscopic retrograde cholangiography (ERC) demonstrated rupture of the hepatic duct at its bifurcation which had been missed on initial laparotomy. ERC was valuable in planning and subsequently performing a hepatojejunostomy. We found no previous report of using ERC to diagnose and locate a missed bile duct injury.