[Intra-hepatic post-traumatic cholestasis. Apropos of 22 cases]

The authors report 22 observations of patients showing an intra-hepatic cholestasis following a traumatism. The frequency of this complication amounted to about 1.5 p. 100. Among the mechanisms of this cholestasis some factors were kept in mind: 1. the severity of the traumatism; 2. the surgical act; 3. the use of massive transfusions, the polyvisceral complications of the traumatic shock, the infectious complications. The pathophysiology of this cholestasis seems to be in relation to an increase of the production of the conjugated bilirubin. This production is associated with a decrease of the biliary excretion depending essentially on hepatic intracellular injury, secondary to: the hemorragic shock, the anoxia, the surgical intervention, the infection. From these different factors, they draw practical conclusions as much in the diagnosis of cholestasis as in the therapeutics.