Anesthetics Consideration and Literature Review in Traumatic Biliothoracic Fistula

Abstract

The literature is sparse about anesthetic management for thoracobiliary fistula (TBF) correction surgeries. A gunshot wound victim to the right thoracoabdominal region presented a green colored secretion draining from the right hemithorax during the postoperative period. Laboratory analysis of the secretion along with ultrasound and CT scan confirmed the clinical suspicion of pleurobiliary fistula (PBF). Laparotomy with diaphragm and liver repair plus thoracic drainage was performed. The patient was discharged home after an uneventful postoperative recovery and returned 15 days later for follow-up visit without complaints. PBF is a clinical condition prone to complications and its recognition along with the differential diagnosis from BBF is important to determine which anesthetic and surgical measures should be taken. Anesthesia for PBF correction should preconize appropriate analgesia and remain vigilant to the risk of cardiovascular instability during fistula correction.