TRAUMATIC THORACOBILIARY FISTULAS: DIAGNOSIS AND TREATMENT

Thoracobiliary fistulas are commonly reported complications of subphrenic or liver abscesses and biliary tract obstruction. However, they are a rare and unusual complication of hepatic trauma due to traumatic thoracoabdominal wounds. Errors in diagnosis and management of the initial injury involving the diaphragm and liver may increase morbidity and mortality. Due to rarity, the experience of any one surgeon is minimal, and there is a paucity of information available in the literature regarding their treatment. In this report three patients with post-traumatic thoraco-biliary fistula are presented and thirty-five cases previously described in the English literature are reviewed.

ATEÞLÝ SÝLAH YARALANMASINA BAÐLI OLUÞAN TORAKOBÝLÝYER FÝSTÜLLERÝN TANI VE TEDAVÝSÝ

Karaciðer absesi, subfrenik abseler yada safra yolu obstrüksiyonlarý torakobiliyerfistül oluþumunun baþlýca nedenleridir. Torakoabdominal yaralanma sonucu oluþan hepatik travmaya baðlý torakobiliyer fistül oluþumu ise oldukça nadirdir. Bu tür travmalarda meydana gelen hepatik ve diyafragma yaralanmalarýnýn tanýsý ve tedavisindeki gecikmeler morbidite ve mortalitenin artmasýna neden olmaktadýr. Ayný zamanda travmatik torakobiliyer fistüllerin nadir görülmesinden dolayý bu konuda yeterli tecrübeye sahip cerrah sayýsý da oldukça azdýr. Makalemizde torakoabdominal yaralanma nedeniyle yapýlan takip ve tedavilerinde torako-biliyer fistül saptanan 3 hasta Ýngilizce literatürde þimdiye kadar yayýnlanan 35 olgu eþliðinde incelenmiþtir.