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Tue, 8 Jan 2002 04:02:17 EST

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In a message dated 1/8/2002 1:21:01 AM Eastern Standard Time, 
junpangilinan@yahoo.com writes:

> Suspecting a biliary-cutaneous fistula a soft Fr 10
> rubber catheter was inserted into the cutaneous
> opening and a fistulogram was done. This revealed
> opacification of the gall bladder and intra hepatic
> ducts. There was no spillage of contrast into the
> peritoneal cavity

seems like the fistulogram failed and should be repeated 
it showed a connection between the biliary tree and the surface you just 
didnt identify how the contrast media arrived in the biliary tree. 
whether there is aplace for nonoperative management depends upon the location 
of the fistula and the condition of the outflow tract of the biliary tree. If 
there is no obstruction you probably can control the fistula by drainage
if the main duct is injured or obstructed, then percutaneous drainage wont 
work

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<HTML><FONT FACE=arial,helvetica><BODY BGCOLOR="#ffffff"><FONT  style="BACKGROUND-COLOR: #ffffff" SIZE=2>In a message dated 1/8/2002 1:21:01 AM Eastern Standard Time, junpangilinan@yahoo.com writes:<BR>
<BR>
<BR>
<BLOCKQUOTE TYPE=CITE style="BORDER-LEFT: #0000ff 2px solid; MARGIN-LEFT: 5px; MARGIN-RIGHT: 0px; PADDING-LEFT: 5px">Suspecting a biliary-cutaneous fistula a soft Fr 10<BR>
rubber catheter was inserted into the cutaneous<BR>
opening and a fistulogram was done. This revealed<BR>
opacification of the gall bladder and intra hepatic<BR>
ducts. There was no spillage of contrast into the<BR>
peritoneal cavity</BLOCKQUOTE><BR>
<BR>
seems like the fistulogram failed and should be repeated <BR>
it showed a connection between the biliary tree and the surface you just didnt identify how the contrast media arrived in the biliary tree. <BR>
whether there is aplace for nonoperative management depends upon the location of the fistula and the condition of the outflow tract of the biliary tree. If there is no obstruction you probably can control the fistula by drainage<BR>
if the main duct is injured or obstructed, then percutaneous drainage wont work<BR>
</FONT></HTML>
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