Biliary stricture due to neuroma after an innocent blunt abdominal trauma.
A traumatic neuroma of the biliary tract is rarely associated with biliary obstruction. However, when it arises in the common bile duct (CBD) and is associated with obstructive jaundice, it is difficult to distinguish it from bile duct cancer. We describe a patient who developed obstructive jaundice and itching, due to CBD stricture, 8 years after innocent blunt abdominal trauma. The stricture was resected and hepatico-jejunal anastomosis was performed. Histological examination revealed a traumatic neuroma and a fibrous scar around the common bile duct. Symptoms disappeared following surgical removal of the lesion. Blunt abdominal injury may cause the late onset of a fibrous scar and traumatic neuroma in the common bile duct. To our knowledge, a traumatic neuroma of the biliary tract after blunt abdominal trauma has not been reported previously. We review the clinical picture of this relatively rare problem, along with its diagnosis, pathogenesis and treatment.
Katsinelos
P
P
Department of Endoscopy and Motility Unit, Central Hospital, Thessaloniki, Greece. pantso@the.forthnet.gr
Dimiropoulos
S
S
Galanis
I
I
Tsolkas
P
P
Paroutoglu
G
G
Arvaniti
M
M
Katsiba
D
D
Baltaglannis
S
S
Pilpilidis
I
I
Papagiannis
A
A
Vaslliadis
I
I
D000007:Abdominal Injuries / Q000150:complications*; D001661:Biliary Tract Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods; D001651:Cholestasis, Extrahepatic / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009463:Neuroma / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014949:Wounds, Nonpenetrating / Q000150:complications*