Video-assisted laparoscopic approach to biliary tract obstruction caused by a firearm projectile: Case report
DOI:
https://doi.org/10.69849/jg3jh091Keywords:
Wounds Gunshot, Bile Ducts, Cholangitis, Biliary Tract Surgical ProceduresAbstract
Introduction: Projectile migration to the biliary tree is an extremely rare complication of penetrating abdominal trauma, which may manifest late with signs of biliary obstruction. Case report: A 23-year-old male patient with a gunshot wound to the right hypochondrium initially managed conservatively. Thirteen months after the trauma, he presented with pain in the right hypochondrium and signs of cholestasis. Computed tomography showed a projectile in the bile ducts with dilation of the biliary system. Endoscopic retrograde cholangiopancreatography with papillotomy and placement of a biliary stent for decompression was performed. Subsequently, the patient underwent laparoscopic surgery with intraoperative cholangiography, which confirmed a projectile near the bifurcation of the hepatic duct, and its removal was performed in association with cholecystectomy. He progressed satisfactorily and was discharged on the fifth postoperative day. Discussion: Traumatic injuries to the biliary tree are rare, and delayed migration of projectiles to the common bile duct is even more uncommon. Presentation may occur months or years after the trauma, usually as biliary obstruction. Imaging methods and endoscopic retrograde cholangiopancreatography are essential for diagnosis and management. Conclusion: Projectile migration into the biliary tree is a rare complication of penetrating trauma. Recognition of the traumatic history and a multidisciplinary approach are fundamental for proper diagnosis and treatment.
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Copyright (c) 2026 Giovana dos Santos Couto, Ariane Belota Brasil, Cássio Gabriel Barbosa de Oliveira, Rafaela Rodrigues Caminha, Marcos Santiago Bernardes, Clea de Andrade Costa, Jhyovanna de Castro Fernandes, Álvaro Fellipe da Silva Oliveira, Débora de Sousa Guedes Lopes, Carolina Augusta Dorgam Maués (Autor)
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