Traumatic thoracobiliary fistula: report of a case successfully managed conservatively, with an overview of current diagnostic and therapeutic options.
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.
Department of General Surgery, University of Natal, Medical School, Durban, South Africa.
M H
MH
Sheik-Gafoor
B
B
Singh
J
J
Moodley
D000007:Abdominal Injuries / Q000150:complications; D000328:Adult; D001658:Biliary Fistula / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D004322:Drainage; D006801:Humans; D008099:Liver / Q000293:injuries*; D008297:Male; D010995:Pleural Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D016156:Respiratory Tract Fistula / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D013898:Thoracic Injuries / Q000150:complications; D014948:Wounds, Gunshot / Q000150:complications*