Nonoperative Management of Pneumobilia Following Blunt Abdominal Trauma

Jorge Zequeira ； Pablo Rodriguez

《International Journal of Case Reports and Images (IJCRI)》 2卷12期 (2011/12) Pp. 6-10

https://doi.org/10.5348/ijcri-2011-12-72-CR-2

並列摘要

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. N one 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.

並列關鍵字

Pneumobilia ； Trauma ； Blunt abdominal trauma