Isolated transection of the common duct.

A patient with complete transection of the common bile duct after blunt trauma from a steering wheel presented with severe right-sided lower chest pain. Based on results of physical examination, blood and urine analysis and chest x-ray films, he was discharged after suture of a lip laceration. Five days later upon his return for suture removal, the appearance of jaundice and mild symptoms of abdominal distention prompted hospitalization and exploratory surgery. At surgery, avulsion of the common bile duct was the only injury. In the few previously reported cases of this injury, jaundice and mild symptoms of abdominal distention appeared three to four days after injury. The minimal findings of a potentially fatal lesion emphasize the need for securing appropriate follow-up medical care for patients with a history of blunt trauma to the chest and/or abdomen.