A rare complication of thoracoabdominal trauma

Thoracobiliary fistulas are commonly reported complications of liver abscesses 4. Congenital 3, iatrogenic6 and neoplastic 5 forms have also been reported. However, they are a rare and unusual complication of thoracoabdominal trauma and they present a formidable challenge to the trauma surgeon 1. This complication was first reported by Graham in 1897 6. In 1994, Rothberg et al reviewed these complications and reported only 34 cases of thoracobiliary fistulas in the English literature. Thoracobiliary fistula may communicate with either the pleural space (Pleurobiliary fistula) or the bronchus (Bronchobiliary fistula). A high index of suspicion and early diagnosis are mandatory in order to successfully manage this complication. Given their rarity, there is little consensus on the optimal management.