Changing patterns of traumatic bile duct injuries: a review of forty years experience

Figure 1 Hepatobiliary damages 6 years after HAE with sod. morrhuate:MRI showed atrophy of right liver, hypertrophy of the left lateral segment and obstruc-tion of hepatic duct at the hila hepatis.

Figure 2 Hemangioma of right liver years after HAE. The same patient. MRI showed hemangioma still in place.

Figure 3 Neurilemmoma of the right liver: Resection of the tumr with right-sided tri-segmentectomy resulted into injury ofthe left hepatic duct.

Figure 4 The same case as Fig 3. Retrograde cholangiography of the intraphepatic duct through a PTBD catheter showing obstruction of left intrahepatic ducts and hypetrophy of the left hepatric segment.

Figure 5 Bile duct injury in resection of quadrate lobe hemangioma: MRCP showing marked dilatation of the intrahepatic duct system with suphrenic collection of fluid. Extrahepatic bile duct not visualized.

Figure 6 LC bile duct injury: Bile duct repair by hepatico-jejunostomy of Roux-en-Y tye. Postoperative retrograde cholangiography only the right anterior segmental duct and the left hepatic duct visualized.

Figure 7 The same case. PTC showing the dilated blind end of the right posterior segmental duct which was “missed” during the operation.

Figure 8 Fibrosis and obstruction of hepatic duct following HAE with injection of sodium morrhuate: 2 years after the procedure.

Figure 9 The same case. Necrosis of the gallbladder and the hepatic duct.