[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-443491-105":59,"doc-detail-443491-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","isolated-cystic-duct-injury-caused-by-a-gunshot-wound-a-case-report-of-an-extremely-rare-finding","Isolated Cystic Duct Injury Caused by a Gunshot Wound - A Case Report of an Extremely Rare Finding","","Extrahepatic biliary tree injuries are uncommon, but isolated extrahepatic biliary tree injuries are extremely rare and are often linked to other traumatic damage. Their subtle symptom onset can cause them to be missed during early trauma assessment, contributing to clinically significant morbidity. Management is guided by hemodynamic stability and imaging, ranging from nonoperative care to minimally invasive surgery, open surgery, and/or endoscopy. The report describes a 28-year-old man with a gunshot wound causing cystic duct laceration without associated injuries; acholecystectomy was performed and postoperative recovery was satisfactory.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/isolated-cystic-duct-injury-caused-by-a-gunshot-wound-a-case-report-of-an-extremely-rare-finding/443491/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/isolated-cystic-duct-injury-caused-by-a-gunshot-wound-a-case-report-of-an-extremely-rare-finding/443491.png","ImageObject",300,407,{"name":92,"@type":93},"River Wang","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-08","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",17,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why are isolated extrahepatic biliary tree injuries often overlooked in trauma evaluation?","Question",{"text":113,"@type":114},"They are extremely rare and typically have an insidious onset of symptoms, so they may be missed during initial trauma assessment. This can increase the risk of significant associated morbidity.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How should management of extrahepatic biliary injuries be determined?",{"text":118,"@type":114},"Management depends on hemodynamic stability and imaging findings, and may include nonoperative approaches or surgical/endoscopic treatment. The presence, absence, and severity of associated injuries also guide decision-making.",{"name":120,"@type":111,"acceptedAnswer":121},"What did surgery find and how was the patient treated in this case report?",{"text":122,"@type":114},"Surgery identified a laceration of the cystic duct with no associated injuries. Acholecystectomy was performed, followed by satisfactory postoperative progress and discharge.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},443491,1790767183,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":24,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},1099514067438,"https://ap-avatar.wpscdn.com/avatar/100002539ee87300030?x-image-process=image/resize,m_fixed,w_180,h_180&k=1780474512215547542","Review began 11/11/2025  \nReview ended 12/01/2025  \nPublished 12/06/2025  \n© Copyright 2025  \nDe León Murillo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98592  \nOpen Access Case Report  \nIsolated Cystic Duct Injury Caused by a Gunshot Wound: A Case Report of an Extremely Rare Finding  \nAndrés David De León Murillo 1 , Pedro Antonio Plaza Ricardo 2 , Indira Tatiana Miguel Angel Fuentes Iglesias 3, Sergio A. Tavera 4 , Tatiana Paola Pérez García Alejandro Alfonso Bedoya Rinaldi 1  \nContreras Vanegas 1  \n,  \n3  \n,  \n1. General Surgery, Universidad Libre, Barranquilla, COL 2. General Surgery, Clínica Keralty, Ibagué, COL 3. Medicine, Universidad Metropolitana, Barranquilla, COL 4. Surgery, Universidad Metropolitana, Barranquilla, COL  \nCorresponding author: Andrés David De León Murillo, [andresddeleon@gmail.com](andresddeleon@gmail.com)  \nAbstract  \nExtrahepatic biliary tree injuries are uncommon, but isolated extrahepatic biliary tree injuries are extremely rare and are usually associated with other injuries. The most common associated injuries include liver, spleen, and/or duodenal injuries. Due to their rarity and generally insidious onset of symptoms, extrahepatic biliary tree injuries are often overlooked during the initial trauma evaluation, which can lead to significant associated morbidity. Their management, considering hemodynamic stability and imaging findings, includes nonoperative and surgical management, which may include minimally invasive (laparoscopy), open surgery, and/or endoscopy. We present the case of a 28-year-old male patient admitted with a gunshot wound to the abdomen. Surgical findings included a laceration of the cystic duct, with no associated injuries. Acholecystectomy is performed. Following surgery, the patient made satisfactory postoperative progress and was subsequently discharged.  \nCategories: General Surgery, Emergency Medicine, Trauma  \nKeywords: abdominal trauma, emergency, extrahepatic biliary trauma, extrahepatic biliary tree trauma, trauma  \nIntroduction  \nExtrahepatic biliary tree injuries are uncommon, occurring in 0. 1% of adult trauma admissions, 0.009% of pediatric trauma admissions [1], and 2 .8-7.4% of patients with blunt hepatic trauma [2] . Isolated injuries to the extrahepatic biliary tree are extremely rare, occurring in only 2-3% of cases [1], and are usually associated with injuries. The most common associated injuries include liver injury (91% of cases) and splenicand duodenal injuries (both in up to 54% of cases) [3] . Blunt trauma is the most common cause of extrahepatic biliary tree injuries, except for the gallbladder, which is most frequently injured by penetrating trauma, in up to 89% of cases [1,4] . This low incidence may be secondary to the mechanical protection  \nprovided by the liver [3,4] .  \nDue to their rarity and generally insidious onset of symptoms, extrahepatic biliary injuries are often  \noverlooked during the initial trauma evaluation, which can lead to significant associated morbidity [5,6] .  \nBiliary injury may be evident at the time of initial surgery with the presence of bile drainage through the hepatic parenchyma, the extrahepatic biliary tree, or the pancreas. Postoperatively, biliary injury may be evidenced by the presence of a biliary fistula, biliary peritonitis, bilioma, or biliary stricture. Rarely, a biliary injury may present as a biliopleural, bronchopleural, or biliovenous fistula, or hemobilia [7] .  \nExtrahepatic biliary tract injuries are categorized according to the classification proposed by the American Association for the Surgery of Trauma (AAST), which ranges from Grade I to Grade V, corresponding to  \ncontusion or hematoma of the gallbladder and/or portal triad to transection of more than 50% of the","cbCaibavdwGc0TYK","https://ap.wps.com/l/cbCaibavdwGc0TYK","pdf",3045784,"English","# Abstract\n# Introduction\n# Case Presentation","[{\"question\":\"Why are isolated extrahepatic biliary tree injuries often overlooked in trauma evaluation?\",\"answer\":\"They are extremely rare and typically have an insidious onset of symptoms, so they may be missed during initial trauma assessment. This can increase the risk of significant associated morbidity.\"},{\"question\":\"How should management of extrahepatic biliary injuries be determined?\",\"answer\":\"Management depends on hemodynamic stability and imaging findings, and may include nonoperative approaches or surgical/endoscopic treatment. The presence, absence, and severity of associated injuries also guide decision-making.\"},{\"question\":\"What did surgery find and how was the patient treated in this case report?\",\"answer\":\"Surgery identified a laceration of the cystic duct with no associated injuries. Acholecystectomy was performed, followed by satisfactory postoperative progress and discharge.\"}]","Isolated Cystic Duct Injury Caused by a Gunshot Wound - A Case Report of an Extremely Rare Finding | PDF",1790704237,13]