Biliary-colonic fistula: a case report and literature review.

We report the occurrence of common bile duct obstruction and biliary-colonic fistula after open cholecystectomy. Although it is a very unusual complication after cholecystectomy, biliary-colonic fistula should be part of the differential diagnosis for patients presenting with sepsis after open or laparoscopic cholecystectomy. After confirmation and characterization of the injury by endoscopic retrograde cholangiopancreatography and cholangiogram, assessment for undrained collections by computed tomography scan, control of sepsis and coagulopathy, and nutritional support, surgical repair was undertaken.

Age 14 starts a child's increased risk of major knife or gun injury in Washington, DC.

This retrospective review of eight years of trauma registry data at an inner-city level-1 trauma center was undertaken to discover at what age urban children start to become at high risk of being victims of either a major gunshot wound or stabbing. We reviewed data from 2,191 patients who were the victim of either a gunshot wound or stabbing, were 18 years of age or under, and met pre-established criteria to qualify as a major trauma victim. There was a rise and subsequent fall in both overall crime and intentional injury rates during the eight-year period.