An unusual bile duct injury in a child after blunt abdominal trauma.

Bile duct injuries are rare in children after blunt trauma. This report describes a 3-year-old child who sustained a blunt abdominal trauma resulting in bile duct, liver, and small bowel injuries. The initial management at another hospital included recognition and repair of a small bowel perforation. However, the postoperative course was complicated by a large biliary leak. The child was transferred to our institution where radioisotope scanning and endoscopic retrograde cholangiography confirmed the extent of the ductal injury. At laparotomy there were injuries of both right and left hepatic ducts, and an anomaly of bile duct course was noted. The right hepatic duct was repaired primarily and the left one was repaired with Roux-en-Y hepaticojejunostomy. Postoperatively, normal bile drainage was documented by radioisotope scan and the patient remains symptom free at 1 year follow-up.