Abstract
After surgery for hepatic injury as a result of blunt abdominal trauma from a motorcycle accident, an external biliary fistula developed in a young patient. The authors describe the rapid and complete healing of the fistula by use of a nasobiliary catheter. These findings emphasize the importance of endoscopic operative technique for postoperative and traumatic external biliary fistulas.
Highlights
External biliary fistula is a possible complication of hepatic trauma or hepatic surgery
The authors report a case of external biliary fistula subsequent to an operation for hepatic injury in a patient with blunt abdominal trauma
Only 40 ml of biliary leakage was registered, and 600 ml had been drained from the nasobiliary tube
Summary
External biliary fistula is a possible complication of hepatic trauma or hepatic surgery. Untreated blunt hepatic trauma can cause external fistulas in about 4% of all patients [5]. Endoscopic operative procedures represent a valid and often successful treatment for these kinds of complications in biliary surgery: endoscopic retrograde cholangiopancreatography (ERCP) permits extremely precise diagnosis and allows biliary drainage through. The authors report a case of external biliary fistula subsequent to an operation for hepatic injury in a patient with blunt abdominal trauma. Endoscopic positioning of a nasobiliary drainage tube permitted complete healing of the fistula within a few days. Trans-nasobilary tube cholangiography, performed 5 days later, demonstrated the persistence of leakage of contrast material (Fig. 2) Another cholangiography, performed 12 days after ERCP, demonstrated complete healing of the fistula (Fig. 3). After 40 days of hospital stay, the patient was completely recovered and was discharged
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