Hydatid hepatopleural fistula causing biliothorax: minimally invasive approach with ERCP stent placement and chest tube drainage: a case report

Abstract

Introduction and importance: Biliothorax and hydatid bilio-bronchial fistula (HBBF) are rare complications of hydatid cysts of the liver with high perioperative mortality. Case presentation and clinical discussion: The authors here report the case of a patient with a right massive pleural effusion with evidence of HBBF in imaging studies, who underwent surgical resection of a hydatid cyst of the liver 8 years ago. The patient was managed with intercostal chest tube drainage for biliothorax and endoscopic sphincterotomy with biliary stent placement for the re-establishment of internal biliary drainage, which ultimately allowed the fistulous tract to heal without any major surgical intervention. Conclusion: This article focuses on the successful management of the HBBF at our institution. Our findings emphasize the significance of early diagnosis and the criticality of implementing aggressive and early interventions to minimize complications and fatalities. By examining this specific case and reviewing existing literature, the authors have determined that endoscopic treatment appears to be a viable, secure, and efficacious option for addressing postoperative HBBF.