title: Severe jaundice in a gunshot casualty due to the coexistence of Dubin-Johnson and glucose-6-phosphate dehydrogenase deficiency.
abstract: We report an unusual case of a 21-year-old man who was shot in his abdomen in the course of a robbery. He was previously diagnosed as glucose-6-phosphate dehydrogenase deficient. Mild icterus was noticed on admission to the emergency room. Exploratory laparotomy revealed a perforated ileal loop that was resected, and because the liver color was greenish black, a liver biopsy was performed during the operation. After operation the patient went through a severe icteric state that resolved spontaneously within a few days. Urinary coproporphyrin levels, along with compatible liver biopsy, confirmed the diagnosis of Dubin-Johnson disease. Severe hyperbilirubinemia after an abdominal injury is uncommon and is usually due to either a biliary duct injury or iatrogenic injury. This case presents an unusual cause of severe postoperative jaundice due to the rare coexistence of two inherited disorders.
authors.affiliation: Department of Medicine A, Institute of Pathology, Hillel Yaffe Medical Center, and Hadera Subdistrict Health Office, Israel.
authors.forename: D
authors.initials: D
authors.lastname: Zamir
authors.forename: G
authors.initials: G
authors.lastname: Groisman
authors.forename: C
authors.initials: C
authors.lastname: Zamir
authors.forename: E
authors.initials: E
authors.lastname: Sternberg
authors.forename: M
authors.initials: M
authors.lastname: Iuchtman
authors.forename: R
authors.initials: R
authors.lastname: Alfisi
authors.forename: P
authors.initials: P
authors.lastname: Weiner
mesh_terms: D000007:Abdominal Injuries / Q000150:complications; D000328:Adult; D001706:Biopsy; D005955:Glucosephosphate Dehydrogenase Deficiency / Q000150:complications*; D006801:Humans; D007565:Jaundice / Q000209:etiology*; D007566:Jaundice, Chronic Idiopathic / Q000150:complications*; D008099:Liver / Q000473:pathology; D008297:Male; D014948:Wounds, Gunshot / Q000150:complications*