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Case Report
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| Non-operative management of pneumobilia following blunt abdominal trauma |
| Jorge Zequeira1, Pablo Rodriguez2 |
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1Resident, Department of Surgery, University of Puerto Rico, San Juan, PR, USA.
2Section Chief, Section of Trauma & Critical Care, Department of Surgery, University of Puerto Rico, San Juan, PR, USA. |
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doi:10.5348/ijcri-2011-12-72-CR-2
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Address correspondence to: Jorge J. Zequeira Department of Surgery University of Puerto Rico School of Medicine PO Box 365067 San Juan, PR 00936-5067 USA Phone: 787 403-9370 Email: jorge.zequeira@upr.edu |
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| How to cite this article: |
| Zequeira J, Rodriguez P. Non-operative management of pneumobilia following blunt abdominal trauma. International Journal of Case Reports and Images 2011;2(12):6-10. |
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Abstract
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Introduction:
Pneumobilia is an uncommon finding in imaging studies that may have a myriad of clinical connotations. Taking into consideration that only six cases of pneumobilia following blunt abdominal trauma have been reported, we will add an additional case and discuss the ones that have been documented in the world literature.
Case Report: We will report the case of an elderly male who sustained a motor-vehicle accident with diagnoses of a duodenal contusion and a femur fracture. These diagnoses were associated with the presence of pneumobilia on abdominal imaging. The patient was placed on bowel-rest, nasogastric suction, followed with serial physical exams, and discharged home on the ninth day after admission. Conclusion: Pneumobilia has been associated to diseases that mandate a surgical intervention. Six cases of pneumobilia after a blunt traumatic injury have been reported. Two of these patients were managed operatively while the other four were managed expectantly. None of the patients who were explored had findings suggestive of a surgically-correctable cause of pneumobilia. Those who were managed expectantly were discharged home without complications. The proposed mechanism for this event to occur is retrograde flow of air through the sphincter of Oddi as a consequence of sudden application of extrinsic pressure to the abdomen. Pneumobilia is a rare finding after blunt abdominal trauma that may be treated expectantly although more evidence is needed in order to generalize a management strategy. | |
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Key Words:
Pneumobilia, Trauma, Blunt abdominal trauma
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Author Contributions:
Jorge Zequeira - Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Pablo Rodriguez - Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission:
The corresponding author is the guarantor of submission. |
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Source of support:
None |
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Conflict of interest:
Authors declare no conflict of interest. |
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Copyright:
© Jorge Zequeira et al. 2011; This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see www.ijcasereportsandimages.com /copyright-policy.php for more information.) et. al. 2011; This article is distributed the terms of Creative Commons attribution 3.0 License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.) |
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