[Biliary fistula after concealed choledochal rupture in a polytraumatized patient]

Area of Science:

• Gastroenterology
• Surgical Case Reports

Background:

• Polytrauma management presents complex challenges.
• Post-traumatic complications can manifest years after initial injury.

Observation:

• A patient with polytrauma developed a fistulous wound with initial healing followed by deterioration.
• Diagnostic workup revealed extremely high bilirubin concentrations in wound secretions.

Findings:

• A delayed diagnosis of a common bile duct leak, secondary to the initial trauma, was made.
• The bile duct leak was successfully treated with a biliodigestive anastomosis and a Roux-Y loop, bypassing the distal common bile duct.

Implications:

• Highlights the importance of considering delayed complications in polytrauma patients.
• Demonstrates the efficacy of surgical reconstruction for post-traumatic bile duct injuries.