Traumatic rupture of the common duct in sclerosing cholangitis

A women, 52 years, old, with Crohn's disease of the colon treated with colectomy 9 years earlier, got a blunt abdominal trauma in a car accident. At laparotomy two weeks after the accident an isolated transverse rupture of the common hepatic duct was found just below the confluence of the hepatic ducts. The rupture was successfully repaired by a direct anastomosis. Four years later the patient developed attacks of fever and jaundice. A cholangiogram now showed typical signs of sclerosing cholangitis and re-checking of cholangiograms taken after the primary repair revealed that the disease existed already at that time. The cholangitis is supposed to be a contributing factor to the rupture.