Abstract
We report on a case of a traumatic bile duct stricture with a difficult preoperative diagnosis. A 72 year old woman, who had fallen off her bike 2 weeks prior, presented with jaundice and brownish urine. She was admitted to our hospital with obstructive jaundice. A CT scan showed dilatation of the intrahepatic and extrahepatic bile ducts and a biliary stricture at the level of the superior border of the pancreas. CT and MRI did not reveal a common bile duct stone or neoplastic lesion in the pancreas. Percutaneous transhepatic cholangiodrainage was conducted. Examinations conducted to investigate the cause of the biliary stricture precluded primary sclerosing cholangitis, IgG4-related diseases, and autoimmune pancreatitis. Given that bile duct carcinoma was a possible cause of the biliary stricture, we performed pancreatoduodenectomy. Pathological examination revealed no malignancy lesions ; thus, we diagnosed traumatic bile duct stricture. Benign biliary stricture is often difficult to distinguish from bile duct carcinoma. Even a slight blunt abdominal trauma may cause bile duct stricture.
