Traumatic Thoracobiliary (Pleurobiliary and Bronchobiliary) Fistulas

Bronchobiliary fistula: an anesthetic challenge!

“…Post-traumatic bronchobiliary fistula is also a rare complication of thoracoabdominal trauma [7][8][9][10][11]. With an increasing frequency of combined chest and abdominal injuries, greater incidence of concomitant diaphragmatic and hepatic wounds may be expected.…”

Bronchobiliary Fistula Successfully Treated with n-Butyl Cyanoacrylate via a Bronchial Approach

“…Traditionally, definitive treatment for a BBF involved extensive surgery through either a transthoracic or transabdominal approach, with excision of the fistulous tract, repair of the diaphragmatic defect, abscess drainage, pulmonary or hepatic resection if appropriate, and interposition of healthy tissue in between the lung and liver (3,8,(11)(12)(13). These operative procedures carried significant morbidity and mortality and often required multiple reoperations (2).…”

Bronchobiliary fistula after hepatic resection for metastatic colon cancer

“…The presenting symptoms are commonly fever, biliptysis, and abdominal and chest pain. In Oparah and Mandal's study of traumatic thoracobiliary fistulas, bile expectoration ranged from production of moderate amounts of bile-stained sputum to large amounts of frank bile [2]. Suspicious sputum samples can be readily screened for bile content by most laboratories.…”

“…For patients who are not surgical candidates there may be less-invasive alternatives. Oparah and Mandal state that if performed early, adequate percutaneous control of subphrenic fluid together with tube thoracostomy should resolve most traumatic thoracobiliary fistulas [2]. Cropper et a1 also reported a case of traumatic bronchobiliary fistula successfully treated by percutaneous drainage of a subphrenic abscess and antibiotics [6].…”