Traumatic Common Bile Duct Injury: Primary Repair without Internal Drainage after Penetrating Abdominal Trauma. A Case Report and Literature Review

Common bile duct (CBD) injuries are most often iatrogenic and rarely caused after penetrating abdominal trauma. Their diagnosis is frequently delayed due to non-specific clinical and imaging findings. We present the case of a 36- year-old male with combined CBD and liver injury following a stab wound.
Initial assessment revealed stable vital signs and non-specific abdominal findings. CT imaging demonstrated liver lacerations and a small volume of free fluid. During clinical observation, the abdominal signs worsened, prompting surgical exploration. Emergency laparoscopy revealed greenish discoloration in the hilar plate and the procedure was converted to an open laparotomy, which confirmed CBD laceration.
Primary repair without stent or T-tube placement was performed, with an adjacent drain. Postoperative recovery was uneventful; follow-up MRCP in one month showed no stricture. This report highlights the feasibility of primary repair without stenting in select traumatic CBD injuries.

Keywords: common bile duct injury, penetrating trauma, primary repair, laparotomy, biliary surgery

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