Biliary peritonitis due to laparoscopic bile duct injury

Moderate amount of abdominal free fluid mainly around the liver, spleen, gallbaddergallbladder fossa, and in the paracolic gutters with free intraperitoneal gas (postoperative). Thickening with an enhancement of the peritoneal reflections.

The MRCP (source images and 3D) shows a small connection between the fluid collection in the gallbladder fossa and the common bile duct just above the cystic duct remnant and 1.7 cm from the biliary confluence.

A short stricture with well-defined margins is seen at the upper portion of the common hepatic ductwith no dilatation of the intrahepatic biliary tree in keeping with a pseudostricture or pseudonarrowing due to a vascular impression.

MRI features of biliary peritonitis due to iatrogenic bile duct injury following laparoscopic cholecystectomy (type E2 acordingaccording to Strasberg classification of bile duct injury ) that was confirmed at surgery.

 BileBile duct injuries may occur after gallbladder, gastric or pancreas surgery, more frequent with laparoscopic cholecystectomy as in this case.