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Ann Thorac Surg 2002;73:1645-1647
© 2002 The Society of Thoracic Surgeons

Case report

Bullets and biliptysis

John J. Nigro, MD, MS*a, Hector Arroyo, Jr, MDb, Demitri Theodorou, MDb, George C. Velmahos, MD, PhDb, Ross M. Bremner, MD, PhDa

a Department of Cardiothoracic Surgery, Keck School of Medicine, University of Southern California, Los Angeles County University of Southern California Medical Center, Los Angeles, California, USA
b Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles County University of Southern California Medical Center, Los Angeles, California, USA

Accepted for publication October 10, 2001.

* Address reprint requests to Dr Nigro, Department of Cardiothoracic Surgery, Keck School of Medicine, University of Southern California, USC Health Science Consultation Center, 1510 San Pablo St, Suite 415, Los Angeles, CA 90033, USA
e-mail: jnigro{at}hsc.usc.edu

Biliptysis is a dramatic physical finding which suggests the presence of a direct communication (fistula) between the biliary and bronchial tree. We report a bronchial biliary fistula resulting from penetrating thoracoabdominal trauma and the use of positive-pressure ventilation to obtain initial fistula control prior to definitive surgical repair.






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