Document Detail

Impaction of a shrapnel splinter in the common bile duct after migrating from the right thoracic cavity: report of a case.
MedLine Citation:
PMID:  12027209     Owner:  NLM     Status:  MEDLINE    
Biliary obstruction is rarely caused by a foreign body. This report describes the case of a 60-year-old Japanese man with jaundice caused by an impacted shrapnel splinter in the common bile duct (CBD) that had migrated from the right thoracic cavity 36 years after initial injury. Biochemical data showed a total bilirubin level of 4.2 mg/dl with a direct bilirubin level of 3.1mg/dl, an alanine aminotransferase level of 24IU/l, and an alkaline phosphatase level of 18.5KA units. It was serially documented that the shrapnel had migrated toward the diaphragm, then burrowed into the liver, settling in the CBD, and causing obstructive jaundice. Choledochotomy and T-tube drainage was performed and the postoperative course was uneventful. To our knowledge, this is the first case report of this type of occurrence in the Japanese literature. Although there are few reports of combat injury in Japan, this diagnosis should be considered in the evaluation of any patient with jaundice who has suffered a previous chest wound involving a foreign body.
Susumu Eguchi; Shigetoshi Matsuo; Masaaki Hidaka; Takashi Azuma; Satoshi Yamaguchi; Takashi Kanematsu
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Surgery today     Volume:  32     ISSN:  0941-1291     ISO Abbreviation:  Surg. Today     Publication Date:  2002  
Date Detail:
Created Date:  2002-05-24     Completed Date:  2002-11-18     Revised Date:  2006-08-03    
Medline Journal Info:
Nlm Unique ID:  9204360     Medline TA:  Surg Today     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  383-5     Citation Subset:  IM    
Department of Surgery, Nagasaki Prefectural Shimabara Onsen Hospital, Nagasaki, Japan.
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MeSH Terms
Cholestasis, Extrahepatic / etiology*
Common Bile Duct Diseases / etiology*
Foreign-Body Migration / complications*
Middle Aged
Thoracic Cavity
Thoracic Injuries / etiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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