WATCH AND WAIT OR OPERATION: SOME SUGGESTIONS FOR EARLY DIAGNOSIS AND TREATMENT OF TRAUMATIC THORACO-BILIARY FISTULAS

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MONTAZERI V.

مرکز اطلاعات علمی Scientific Information Database (SID) - Trusted Source for Research and Academic Resources

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Journal: Journal of Medical Council of Iran Year:2000 | Volume:18 | Issue:1 Page(s): 17-23

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Title

WATCH AND WAIT OR OPERATION: SOME SUGGESTIONS FOR EARLY DIAGNOSIS AND TREATMENT OF TRAUMATIC THORACO-BILIARY FISTULAS

Author(s)

MONTAZERI V. | Issue Writer Certificate

Keywords

BILE EXPECTORATIONQ4

BILIOUS EMPYEMAQ4

PROMPT THORACOTOMYQ4

Abstract

A report of 9 wounded victims with thoraco - biliary fistulae along with a review of 35 cases reported in English - literature till now is the main content of this article.All the patients had liver and diaphragmatic injuries. In 6 cases, the fistula was pleuro - biliary, in one case broncho'- biliary, and in 2 cases it had been pleuro - broncho - biliary.The simplest diagnostic approach to pleuro, biliary fistula is to analyze the pleural-fluid for bilirubin. Biliptysis is pathognomonic of the broncho - biliary type and is definitely dangerous than pleura - biliary type. In order to avoid and overcome the fatal complications of it (biliary aspiration), patients should undergo immediate thoracotomy, repair of diaphragmatic tears, proper pulmonary resections etc.But in pleuro - biliary type the first therapeutic step is to drain the pleural space (Tube thoracostomy) along with the drainage of subdiaphragmatic space (Extraperitoneal), but paticnts whose fistulae continue to drain after 2 to 3 weeks or are complicated by thick bilious cmpyema there is a need for more aggressive approach such as thoracotomy, decortication and diaphragmatic repair. Despite the fact that thoraco- biliary fistulae are highly dangerous by themselves and may cause other fatal and dangerous complications, rapid and early diagnosis associated with appropriate and invasive operative measures will result in insignificant effects and insignificant mortality secondary to them would decrease.

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APA: Copy

MONTAZERI, V.. (2000). WATCH AND WAIT OR OPERATION: SOME SUGGESTIONS FOR EARLY DIAGNOSIS AND TREATMENT OF TRAUMATIC THORACO-BILIARY FISTULAS. JOURNAL OF MEDICAL COUNCIL OF I.R.I., 18(1), 17-23. SID. https://sid.ir/paper/41280/en

Vancouver: Copy

MONTAZERI V.. WATCH AND WAIT OR OPERATION: SOME SUGGESTIONS FOR EARLY DIAGNOSIS AND TREATMENT OF TRAUMATIC THORACO-BILIARY FISTULAS. JOURNAL OF MEDICAL COUNCIL OF I.R.I.[Internet]. 2000;18(1):17-23. Available from: https://sid.ir/paper/41280/en

IEEE: Copy

V. MONTAZERI, “WATCH AND WAIT OR OPERATION: SOME SUGGESTIONS FOR EARLY DIAGNOSIS AND TREATMENT OF TRAUMATIC THORACO-BILIARY FISTULAS,” JOURNAL OF MEDICAL COUNCIL OF I.R.I., vol. 18, no. 1, pp. 17–23, 2000, [Online]. Available: https://sid.ir/paper/41280/en

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