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Posttraumatic cholothorax in a child: case report and review of the literature

Anke Waelbers1, Elisabeth L I M Duval, D Vervloessem

  • 1Paediatric Intensive Care Unit, and the Department of Paediatric Surgery, Queen Paola Children's Hospital, Lindendreef 11, Antwerp, Belgium.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|April 29, 2005
PubMed

Insights

Thoracobiliary fistula, a rare complication of blunt trauma, requires high suspicion for diagnosis. Conservative management, including drainage and antibiotics, proved successful in a pediatric case, suggesting a viable nonoperative approach.

Area of Science:

  • Pediatric Surgery
  • Trauma Management
  • Gastroenterology

Background:

  • Thoracobiliary fistula is a rare complication following blunt thoracoabdominal trauma.
  • Its rarity, particularly in children, leads to diagnostic challenges and a lack of established management guidelines.

Observation:

  • A 4-year-old girl developed a cholothorax after blunt thoracoabdominal trauma.
  • The patient was successfully treated with conservative measures: drainage, antibiotics, and a low-fat diet.

Findings:

  • Delayed diagnosis of diaphragmatic injury, often due to conservative trauma assessment, can contribute to fistula formation.
  • Endoscopic retrograde cholangiopancreatography (ERCP) is highlighted as a preferred diagnostic and potentially therapeutic imaging modality.
  • A nonoperative approach demonstrated success in this pediatric case.

Implications:

  • This case underscores the importance of considering thoracobiliary fistula in pediatric blunt trauma patients.
  • Conservative management may be a successful alternative to surgical intervention for selected cases.
  • Further research into optimal diagnostic and therapeutic strategies for pediatric thoracobiliary fistula is warranted.
Abstract

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