Left hepatic duct injury and thoracobiliary fistula after abdominal blunt trauma

Thoracobiliary fistula after blunt hepatic trauma is rare. We report a case of pleurobiliary fistula after a blunt hepatic trauma leading to a left he patic lobe laceration together with a left hepatic duct injury. The managem ent of this traumatic lesion is discussed and related to the existing liter ature data. The diagnosis of traumatic thoracobiliary fistula rests upon cl inical suspicion in the setting of a persistent right pleural effusion. Dem onstration of the presence of bile in the pleural cavity by thoracocentesis is considered a proof of pleural biliary fistula. We think that laparotomy is an appropriate route for the treatment of pleurobiliary fistulas. Howev er, when a bronchobiliary fistula is suspected, the patient should be treat ed with thoracotomy and may require pulmonary resection to remove the fistu lous tracts.