Isolated intrahepatic bile duct injury secondary to blunt abdominal trauma: A case report and literature review

Closed trauma-induced extrahepatic bile duct injuries have been occasionally reported. However, isolated intrahepatic bile duct injuries are extremely rare due to the deep location of the intrahepatic bile ducts and the protection provided by surrounding vital blood vessels and organs. We report a case of a 50-year-old female who sustained an incomplete rupture of the left hepatic bile duct following a car accident. The patient was urgently transferred to a nearby hospital for treatment after the incident. On the 15th day of hospitalization, she developed abdominal distension, nausea, indigestion, and white stool. Large volumes of dark green ascitic fluid were drained via ultrasound-guided abdominal paracentesis. The patient requested further specialized diagnosis and treatment and was subsequently transferred to our hospital. Ultimately, percutaneous transhepatic cholangiography (PTC) revealed contrast agent extravasation from the left intrahepatic bile duct, confirming a traumatic bile duct injury. The patient underwent left hemihepatectomy on the 30th day post-injury and was discharged on the 12th postoperative day following a successful recovery.