Congenital tracheobiliary fistula treated with biological glue plugging under bronchoscopic guidance: a case report and literature review

Abstract

Objective To investigate the clinical characteristics, diagnosis and treatment of congenital tracheobiliary fistula (CTBF) in children. Methods A case of CTBF admitted into the Department of Pediatric Respiration, Hubei Maternal and Child Health Care Hospital in 2016 was reported, and the related literatures were reviewed.The clinical features, diagnostic methods, treatment status and clinical outcomes of the disease were analyzed. Results The patient was 3 years and 7 months old.The main clinical manifestations were recurrent cough, pneumonia and atelectasis.CTBF was diagnosed by means of iodine oil radiography and treated with biological glue plugging under bronchoscopic guidance.So far, only 30 cases of CTBF have been reported in the English literatures, but only 2 cases in the Chinese literatures.The main clinical manifestations were cough, dyspnea, sputum or bile vomiting, aspiration pneumonia, atelectasis or emphysema.Diagnostic methods for CTBF included bronchoscopy, bronchial angiography and cholangiography, hepatobiliary scan, CT scan and magnetic resonance imaging.Except for this case treated with biological glue plugging under bronchoscopic guidance, all other patients were treated with surgery.The operation methods included fistula ligation, gastrostomy, liver resection, fistula jejunum Roux-en-Y anastomosis, hepatic hilum jejunum anastomosis, gallbladder jejunum anastomosis, etc.Only 4 cases died, and the rest of the patients recovered. Conclusions CTBF should be suspected in children with persistent chronic cough.Iodine oil radiography through bronchoscopy is a simple and feasible method for diagnosis of CTBF.Besides surgery, the lavage and the biological glue plugging method through bronchoscopy is also an effective way to treat CTBF in children without severe biliary malformation. Key words: Congenital tracheobiliary fistula; Bronchoscopy; Iodine oil radiography; Biological glue plugging