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 m ay present a diagnostic and therapeutic challenge. We report a case of a thoracobiliary fistula complicating thoracoabdominal trauma. Althou gh numerous imaging modalities are able to detect the condition, optim al imaging is achieved with endoscopic retrograde cholangiography, whi ch 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 th at is necessary provided that controlled drainage of the fistula is ac hieved. The current recommendation would be the exhaustion of nonopera tive therapeutic modalities before resorting to surgical intervention.