Isolated blunt trauma injury to the hepatic duct.

Isolated bile duct injuries are quite rare. The diagnosis may be difficult. The presence of continued abdominal pain, nausea, vomiting, distention and jaundice in addition to abnormal liver function tests and often a leukocytosis mandate that a biliary tract injury be ruled out. The most important diagnostic study for confirming a biliary tract injury is paracentesis. The ERCP is then done to delineate the anatomy of the injury. Transhepatic cholangiography is an alternative to the ERCP. Treatment for a biliary duct injury must be selected on an individual basis.