Traumatic pneumobilia after cardiopulmonary resuscitation

Pneumobilia is a rare pathological finding, which denotes an abnormal connection between the gastrointestinal and the biliary tract. In the absence of surgically created anastomosis between the bowel and the bile duct, the most common causes for pneumobilia are gallstone obstruction, endoscopic interventions, or emphysematous cholecystitis. We present this case of a middle-aged multiple-injured male who developed traumatic pneumobilia after cardiopulmonary resuscitation. We suppose that chest compression in combination with a sphincter of Oddi (SO) dysfunction forced intraluminal air retrograde through the SO into the biliary tract, since intraabdominal injury as well as former biliary pathology, inflammation, or biliary-enteric fistula were excluded.