Non operative management of blunt bile duct injuries in children

Abstract

Bile duct injuries after blunt abdominal trauma are rare in children. This report describes 2 cases of blunt bile duct injuries in children, which were managed non-operatively. One patient sustained partial tear in the right hepatic duct, which was managed successfully by passing a stent into the injured duct during endoscopic retrograde cholangio pancreatography. The 2nd patient had intrahepatic bile duct injury associated with liver trauma and was managed with a drain placed in the sub-hepatic area percutaneously. This non-operative management in our patients allowed healing of bile duct injuries without any stricture, at 2 years follow-up. Both children are symptom free with normal liver function tests and normal liver ultrasound. With the advancement in radiological and endoscopic techniques, some of the bile duct injuries can be managed conservatively. Conservative treatment must be individualized according to the site and extent of injury.