A biliopleural fistula (BPF) is a rare and atypical manifestation of thoracoabdominal trauma. A stepwise approach for the management is recommended for a successful outcome. We report a case of a 22-year-old man who was referred to our hospital with respiratory discomfort after sustaining a gunshot injury in the right axilla. On investigations he had haemopneumothorax, central liver contusion with perihepatic fluid and a bullet lodged at the level of right renal hilum. He was at first managed by placing a right intercostal tube drain, which initially drained blood and subsequently started draining bile. He was managed successfully with endoscopic biliary stenting, pigtail drainage of subphrenic collection and antibiotics.
2015 BMJ Publishing Group Ltd.