BILIARY STRICTURE CAUSED BY BLUNT ABDOMINAL-TRAUMA - CLINICAL AND RADIOLOGIC FEATURES IN 5 PATIENTS

PURPOSE: To evaluate the clinical and radiologic features of biliary s tricture after blunt abdominal trauma and to report the results of end oscopic stent placement. MATERIALS AND METHODS: Medical records and ra diologic findings were reviewed in five patients with biliary strictur e after blunt abdominal trauma. The level, length, and contour of the strictures were analyzed with endoscopic retrograde cholangiopancreato graphy (ERCP). Computed tomographic (CT) scans were also reviewed to d etermine the presence of biliary dilatation, configuration of the inju red bile duct, and ancillary abdominal findings. Results from endoscop ic stent placement were evaluated in all patients. RESULTS: Stricture occurred in the suprapancreatic portion of the common bile duct in fou r patients and in the intrapancreatic portion in one patient. At ERCP, the stricture contour was concentric and smooth in three patients, ec centric and smooth in one, and abruptly terminated in one. CT showed a brupt narrowing of the common bile duct with dilatation of the proxima l portion in all patients. Endoscopic stent placement was successful i n all patients. CONCLUSION: Patients with biliary stricture after blun t abdominal trauma exhibit a delayed onset of symptoms. A correct diag nosis may be difficult on the basis of findings from CT or ERCP alone without a clinical history of evidence of contusions at other sites.