title: A rare case of hepatic duct injury from blunt abdominal trauma.
abstract: BACKGROUND
  A 25 year-old male was brought to the emergency room following an apparent suicide attempt by jumping from the fourth floor.
  
  
  METHODS
  Patient had a large abdominal laceration in the right upper quadrant (RUQ). CT scan showed a sub-scapular hematoma of the liver. Due to the repeated episodes of hypotension, a laporotomy was performed and the left hepatic artery was ligated while the ductal injury was managed with a Roux-en-Y left hepatic jejunostomy and stent. Bile leakage was resolved post-operatively by day 5 and the patient was discharged home on day 13 after clearance from psychiatry.
  
  
  CONCLUSIONS
  While non-iatrogenic extrahepatic biliary trauma is rare, a high degree of suspicion is essential, especially in cases like the one discussed in this report. Diagnosis can be difficult in patients undergoing observation.
authors.affiliation: Department of Surgery, School of Medicine, Loma Linda University, Loma Linda, CA, U.S.A. ; Department of Surgery, John A. Burns School of Medicine, University of Hawaii and Research Laboratory at the Queen's Medical Center, Honolulu, HI, U.S.A.
authors.forename: Nahidh W
authors.initials: NW
authors.lastname: Hasaniya
authors.forename: Shyamal
authors.initials: S
authors.lastname: Premaratne
authors.forename: Ishani D
authors.initials: ID
authors.lastname: Premaratne
authors.forename: J Judson
authors.initials: JJ
authors.lastname: McNamara
keywords: abdominal laceration; gall bladder; hepatic artery; jejunostomy