title: Traumatic pneumobilia after cardiopulmonary resuscitation.
abstract: Pneumobilia is a rare pathological finding, which denotes an abnormal connection between the gastrointestinal and the biliary tract. In the absence of surgically created anastomosis between the bowel and the bile duct, the most common causes for pneumobilia are gallstone obstruction, endoscopic interventions, or emphysematous cholecystitis. We present this case of a middle-aged multiple-injured male who developed traumatic pneumobilia after cardiopulmonary resuscitation. We suppose that chest compression in combination with a sphincter of Oddi (SO) dysfunction forced intraluminal air retrograde through the SO into the biliary tract, since intraabdominal injury as well as former biliary pathology, inflammation, or biliary-enteric fistula were excluded.
authors.affiliation: Department of Surgery Innenstadt, Klinikum der Universität München, Nussbaumstrasse 20, D-80336 Munich, Germany. Thomas.Mussack@med.uni-muenchen.de
authors.forename: R
authors.initials: R
authors.lastname: Ladurner
authors.forename: D
authors.initials: D
authors.lastname: Kotsianos
authors.forename: W
authors.initials: W
authors.lastname: Mutschler
authors.forename: T
authors.initials: T
authors.lastname: Mussack
mesh_terms: D001659:Biliary Tract / Q000000981:diagnostic imaging / Q000503:physiopathology; D016887:Cardiopulmonary Resuscitation; D002316:Cardiotonic Agents / Q000627:therapeutic use; D035641:Chest Wall Oscillation / Q000379:methods*; D004837:Epinephrine / Q000627:therapeutic use; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology* / Q000601:surgery; D009803:Sphincter of Oddi / Q000503:physiopathology; D036542:Tomography, Spiral Computed; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000503:physiopathology
chemical_list: D002316:Cardiotonic Agents; D004837:Epinephrine