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Selective surgical ligation for post-traumatic arterio-biliary fistula

Abdelrahim, Walid Elhaj (Department of Surgery, Faculty of Medicine, University of Khartoum, P.O. Box 102, Sudan ) ; Dabora, Abdelrahim Ali (Department of Surgery, Faculty of Medicine, University of Khartoum, P.O. Box 102, Sudan ) ; Elsiddig, Kamal Elzaki (Department of Surgery, Faculty of Medicine, University of Khartoum, P.O. Box 102, Sudan ) ; Papamichail, Michail (Lahey Clinic, Department of Transplantation, 41 Mall Road, Burlington, MA 01805, USA ) ; Khalil, Eltahir Awad Gasim (Institute of Endemic Diseases, University of Khartoum, POB 45235, Sudan ) ; Akoad, Mohamed Elhassan (Lahey Clinic, Department of Transplantation, 41 Mall Road, Burlington, MA 01805, USA ) ;
  • 초록  

    Abstract Blunt abdominal trauma is a rare cause of intra-hepatic arterio-biliary fistula and pseudo-aneurysm. Surgery often indicated in cases that fail transcatheter arterial embolization (TAE). In this report we present a case of post-traumatic arterio-biliary fistula with intra-hepatic pseudo-aneurysm in a 10-year-old female patient. She presented with two episodes of massive hematemesis/melena and severe colicky epigastric pain of 5 days duration. Following informed consent from guardians, intra-operative ultrasound-guided selective clamping and ligation of liver segment 4 arterial and portal branches was performed. In conclusion, blunt abdominal trauma to liver can results in life-threatening arterio-biliary fistula and/or peudo-aneurysm. Selective ligation of pseudo-aneurysm feeders under intra-operative ultrasound guidance is recommended in resource–limited settings when interventional radiology is not available. Highlights Blunt abdominal trauma to liver can result in life-threatening arterio-biliary fistula and/or peudo-aneurysm. A ten years old girl presented with colicky abdominal pain and hematemesis following trauma. Intra-operative ultrasound-guided selective clamping and ligation of liver segment 4 arterial branches was performed. The patient was discharged 5 days later without evidence of biliary tract abnormalities or recurrent pseudoaneurysm.


  • 주제어

    Blunt abdominal trauma .   Hemobilia .   Arterio-biliary fistula.  

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