Abstract
Thoracobiliary fistulae are a rare disorder caused by iatrogenic injury or trauma. Because these fistulae are uncommon, no standard of care has been established, but non-operative management (NOM) is often advised. As a result, endoscopic retrograde cholangiopancreatography (ERCP) appears to be playing a growing role in the treatment of select cases. A 42-year-old male patient involved in a street fight developed a biliopleural fistula as a result of an abdominal penetrating injury. Even in the lack of a clearly defined site of biliary leak, NOM and ERCP have proven to be safe and effective therapy in this case.