Radiological Case

Pericardiobiliary Fistula: A Rare Complication of Penetrating Abdominal Trauma

Craig Chavez, MD; David Golchian, DO; Donald Conn, MD; John Finger, MD


Appl Radiol. 2018;47(8):24-26. 

In This Article


A new pericardial effusion in a patient after penetrating trauma involving disruption of the hepatic parenchyma and diaphragm should raise concern for the possible presence of a pericardiobiliary fistula. Pleural fluid as well as pericardial fluid analysis should be performed and nuclear medicine cholescintigraphy can be utilized as adjunct test to diagnose the presence of a pericardiobiliary fistula. Early ERCP can be diagnostic and therapeutic. Consideration should be made for placement of a biliary stent. The complexity of pericardiobiliary fistula requires a multidisciplinary approach for the diagnosis and management.