Traumatic thoracobiliary fistula: report of a case successfully managed conservatively, with an overview of current diagnostic and therapeutic options
Sheik-Gafoor, M.H.; Singh, B.; Moodley, J.
Journal of Trauma 45(4): 819-821
1998
ISSN/ISBN: 0022-5282 PMID: 9783629 Document Number: 489496
Thoracobiliary fistula is a rare complication of hepatic trauma that may present a diagnostic and therapeutic challenge. We report a case of a thoracobiliary fistula complicating thoracoabdominal trauma. Although numerous imaging modalities are able to detect the condition, optimal imaging is achieved with endoscopic retrograde cholangiography, which provides anatomic delineation and has the therapeutic potential of a sphincterotomy. Conservative therapy consists of a safe temporizing measure during the workup and may, on occasion, be the only therapy that is necessary provided that controlled drainage of the fistula is achieved. The current recommendation would be the exhaustion of nonoperative therapeutic modalities before resorting to surgical intervention.