Closed circuit refeeding biliary drainage in a complex blunt hepatobiliary trauma: A novel technique

Harish Jayaram, Preetham Poddutoor, Jyoti M Bothra, K Lalatendu Kumar

African Journal of Trauma 2016 5(2):58-61

Blunt trauma to the abdomen is common in children causing injuries of varying severity. We present a complex case of hepatobiliary, gastrointestinal, and renal artery injuries needing a tailored management strategy and a novel technique of nutrition for the best possible outcome for the patient. Our patient in this case report had extensive hepatobiliary trauma with complete biliary duct and duodenal transection and renal artery thrombosis. He was managed by staged surgeries comprising biliary diversion and duodenal repair in the first stage and undiversion of the system in the second surgery. This is a novel technique as the nutrition was maintained by a closed circuit of bile redrainage into the jejunostomy tube achieving a physiological drainage pattern and circumventing the need of parental nutrition.

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