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Bile Duct Stricture and Intrahepatic Cystic Formation after Abdominal Injury due to Child Abuse: A Case Report
아동학대에 의한 외상성 간외 담관 협착과 간내 낭종 형성: 증례 보고
JKAPS 2018 Jun;24(1):30-4
Published online June 30, 2018;  https://doi.org/10.13029/jkaps.2018.24.1.30
Copyright © 2018 Korean Association of Pediatric Surgeons.

Kyong Ihn1,2, Eun-Jung Koo3, In Geol Ho1,2, Dongeun Lee2, Seok Joo Han1,2
인 경1,2, 구은정3, 호인걸1,2, 이동은2, 한석주1,2

1Department of Surgery, Yonsei University College of Medicine, 2Department of Pediatric Surgery, Severance Children’s Hospital, Seoul, 3Department of Pediatric Surgery, Keimyung University Dongsan Medical Center, Daegu, Korea
1연세대학교 의과대학 외과학교실, 2세브란스 어린이병원 소아외과, 3계명대학교 동산의료원 소아외과
Received April 15, 2018; Accepted May 15, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
A 6-year-old male who lived with a mother in a single-parent family was referred to the emergency room with multiple traumas. There was no specific finding on CT scan of the other hospital performed 55 days before admission. However, CT scan at the time of admission showed common bile duct (CBD) stenosis, proximal biliary dilatation and bile lake formation at the segment II and III. Endoscopic retrograde biliary drainage was performed, but the tube had slipped off spontaneously 36 days later, and follow-up CT scan showed aggravated proximal biliary dilatation above the stricture site. He underwent excision of the CBD including the stricture site, and the bile duct was reconstructed with Roux-en-Y hepaticojejunostomy. Pathologic report of the resected specimen revealed that the evidence of trauma as a cause of bile duct stricture. While non-iatrogenic extrahepatic biliary trauma is uncommon, a level of suspicion is necessary to identify injuries to the extrahepatic bile duct. The role of the physicians who treat the abused children should encompass being suspicious for potential abdominal injury as well as identifying visible injuries.
Keywords : Child abuse, Bile duct, Multiple trauma, Blunt injury

 

June 2018, 24 (1)