Diagnosis and nonsurgical management of bile leak complicated by biloma after blunt liver injury: report of two cases

We report on two patients with biliary tract injury and associated biloma f ollowing blunt abdominal trauma. Both patients underwent emergency surgery because of hemodynamic instability and bloody peritoneal aspiration. Comput ed tomography in the postoperative days showed severe hepatic parenchymal i njury and the presence of hypodense collections with intraparenchymal and s ubcapsular extension, suggestive for biloma, but otherwise failed to demons trate the exact location of the bile duct injury. One of them underwent tem porary percutaneous drainage. Bile duct injury was well demonstrated on end oscopic retrograde cholangiography (ERCP) and treated by endobiliary stent placement. This report advocates the use of ERCP and endobiliary stenting i n the management of biliary injury resulting from liver trauma.