2016 Volume 30 Issue 3 Pages 312-315
A 52-year-old male was brought to our hospital with a blunt chest trauma. He was diagnosed with multiple right-sided rib fractures, a right open pneumothorax, a liver injury, and a suspected right-sided diaphragmatic injury. He underwent thoracostomy and chest tube placement on his right side. On the third day, bile was seen draining through the chest tube; therefore, endoscopic retrograde cholangiopancreatography was performed. Contrast agent leaked into the pleural cavity during the latter examination, and so endoscopic nasobiliary drainage (ENBD) was conducted. After this procedure, the bile discharge from the thoracic drain decreased. Unfortunately, on the 7th day after admission the patient's respiratory status worsened so he underwent thoracotomy for open drainage and to repair the diaphragmatic injury. During the procedure, we confirmed that the bile leakage into the pleural cavity had stopped. He was discharged on the 63rd day without requiring additional surgery. We concluded that ENBD was effective against the patient's traumatic thoracobiliary fistula.
