Case Of Bronchobiliary Fistula Research Articles

Posttraumatic bronchobiliary fistulae due to foreign body remnants after \xa0a\xa0road traffic injury: a case report

BackgroundBronchobiliary fistula is an extremely rare disease that involves abnormal communication between a hepatic segment and bronchial tree. It is mostly caused by untreated hydatid cyst, liver abscess, iatrogenic stenosis, and, rarely, trauma.Case presentationWe experienced an extremely rare case of bronchobiliary fistula after motor vehicle accident. A 15-year-old Persian boy visited our clinic with chief complaints of persistent pleuritic chest pain, productive cough, weight loss, and fever for 2 months. Coronavirus disease 2019 reverse transcription polymerase chain reaction test was negative. Chest X-ray revealed hazy opacification of right lower lobe. Bronchoalveolar lavage for acid-fast bacillus came back negative. Thoracoabdominal computed tomography scan revealed a collection in segment VIII of the liver communicating with another 13 × 5 cm multiloculated collection in the lower lobe of the right lung, with air foci within the collection. Right posterolateral thoracotomy was performed with the impression of bronchobiliary fistula. Drainage of hepatic collection with debridement, diaphragmatic repair, and open decortication of lung followed by resection of the involved segment of the right lung was performed. Histopathologic evaluations revealed abscess formation in pulmonary tissue, and many multinucleated giant cells were seen that appear to be due to foreign body remnants after previous laparotomy surgery. The foreign body seemed to be the remnants of Surgicel absorbable hemostat.ConclusionsHerein, we report an extremely rare case of a posttraumatic bronchobiliary fistula caused by remnants of Surgicel hemostatic agent. Bronchobiliary fistula is mainly caused by untreated hydatid cyst, liver abscess, iatrogenic stenosis, and, rarely, trauma. Migration and erosion of oxidized regenerated cellulose through the diaphragm seems to be the causative factor of bronchobiliary fistula in this patient.

A Case of Bronchobiliary Fistula After Hepatectomy, Temporarily Treated at the Bedside by Bronchial Occlusion with an Endobronchial Watanabe Spigot

A Case of Bronchobiliary Fistula After Hepatectomy, Temporarily Treated at the Bedside by Bronchial Occlusion with an Endobronchial Watanabe Spigot

Bronchobiliary fistula after hepatectomy: A case report and review of the literature.

Bronchobiliary fistula (BBF) is a rare complication following hepatectomy, and consists of an abnormal intercommunication between the biliary tract and bronchial tree. The management of this rare entity is challenging with limited current evidence to date on how to treat this condition. Herein, a case of BBF following a central hepatectomy and the successive steps of the management was presented. Fourteen months postoperatively, the patient presented to the Oncology Department complaining of new onset fever and expectoration. A computerized tomography scan revealed a BBF and the patient was subsequently referred to our department for further treatment. The surgical team decided that a further operation was required. Using the transabdominal approach, a communication between the initial intrahepatic collection and one inferior lobular bronchus was revealed. Transhiatal removal of fistula was performed with closure of the defect through the abdomen. There was no bile leak through the remaining liver parenchyma. Multidisciplinary management should be considered, taking into consideration the underlying pathology leading to this rare complication. Conservative treatment should be considered first, while surgical resection of the BBF remains an option when other therapies have failed. Surgeons should be aware of this rare complication bile duct injuries during hepatic operations can cause.

Two cases of bronchobiliary fistula: Case report

A bronchobiliary fistula, or a biliobronchial fistula (BBF), is a rare condition. It results from an abnormal connection between the biliary and bronchial trees, and is characterized by pathognomonic bilious sputum with suspicious pneumonia. Traditionally, an infectious disease, such as a hydatid infection, has been known to cause a BBF, but BBFs have recently become associated with tumors. In every case, procedures and treatments differ between centers, from simple conservative management to invasive surgical procedures. This case report presents two patients who had BBF after liver resection. Symptoms of each patients were treated and controlled successfully by percutaneous transhepatic biliary drainage tube insertion. We hope that this report helps in the management of BBF in other cases.

Pleurobiliary fistula caused by catheter in intrahepatic biliary tract

In almost all cases of bronchobiliary fistula, sputum with bile is present but not in pleurobiliary fistula. Pleurobiliary fistula is seen secondary to malignancy or surgery. Bile accumulates in pleural space and causes bilious irritation followed by recurrent pneumonia. In this study, a case of pacreatic head tumor, underwent intrahepatic biliary tract catheter three times, was evaluated. The case was diagnosed with chest x-ray, computerized tomography and biochemical analysis of pleural effusion. Pleurobiliary fistula and information from the literature are presented.

A Case of Bronchobiliary Fistula as a Complication of Radiofrequency Ablation

Bronchobiliary fistula (BBF), defined as an abnormal communication between the biliary duct and bronchial trees, is a very rare condition. Bilioptysis is a pathognomonic finding for BBF. We studied a 58-year-old man, who had a BBF complicated by liver biloma that occurred after radiofrequency ablation. The diagnosis was confirmed by the presence of bile-stained sputum and an Endoscopic Retrograde Cholangio-Pancreatography. BBF was treated successfully by endoscopic sphincterotomy and biliary drainage with insertion of a double pig-tail plastic stent into the biloma. We suggest that the optimal choice of treatment modality for BBF depends on the natural course of the underlying disease, and the status of the biliary stricture.

A Case of Bronchobiliary Fistula after Right Hemihepatectomy

症例は77歳の女性で，スクリーニング目的で施行したCTで肝内胆管後区域枝の拡張を指摘されたため，精査目的で当科に入院した．肝内胆管癌の診断で，肝右葉切除術を施行した．術後19病日に右横隔膜下膿瘍に対して，経皮的ドレナージを施行した．CTでは右胸腔と横隔膜下との交通を有する液体貯留を認めた．さらに胆汁様喀痰の排出を認め，ドレーン造影で右肺下葉の気管支が造影され，bronchobiliary fistulaと診断した．保存的に経過をみていたが十分なドレナージは困難と判断したため，再手術を行い瘻孔を切除した．再手術後胆汁様喀痰は消失し，再手術後46日目に軽快退院した．Bronchobiliary fistulaの報告は少なく，文献的考察を加え報告する．

Diagnosis and treatment of bronchobiliary fistula

To explore the diagnosis and treatment modalities of bronchobiliary fistula (BBF). 2 cases of bronchobiliary fistula were reviewed. The etiology, clinical presentations, diagnosis methods, treatment modalities and prognosis of BBF were studied. BBF can be caused by many diseases, which include liver or lung hydatid cyst, amoebic or bacterial liver abscess, subphrenic abscess and biliary lithiasis. Iatrogenic BBF is increasing in recent days. The characteristic presentation of BBF is recurrent bilioptysis. Diagnosis of BBF is not very difficult with the primary disease,characteristic clinical presentations and image studies. Treatment modalities of BBF include endoscopic drainage, biliary stent or biliary decompression, and surgery. Bilioptysis is the characteristic presentation of BBF. Treatment of BBF should be immediately and appropriated while the diagnosis confirmed. Key words: Bronchobiliary fistula; Radiofrequency ablation; Liver metastasis carcinoma; Biliary lithiasis

Bilioptysis Caused by Bronchobiliary Fistula Secondary to Sclerosing Therapy of Liver Cyst

Bronchobiliary fistula is a rare disorder consisting of an abnormal communication between the bronchial tree and the biliary duct. In Western countries, trauma, postoperative biliary stenosis, and biliary lithiasis are the predominant causative factors of bronchobiliary fistula. Bilioptysis (bile stained sputum) is a pathognomic finding for bronchobiliary fistula. To date, there are just a few reported cases of bronchobiliary fistula after sclerosis of a liver cyst. We describe the case of a 74-year-old woman who developed bronchobiliary fistula after sclerosing therapy of a liver cyst. The diagnosis was confirmed by the presence of bilioptysis and the chest and dynamic liver CT findings. The patient was successfully treated with antibiotics and percutaneous transhepatic catheter drainage.

Bronchobiliary fistula: an anesthetic challenge!

A case of bronchobiliary fistula is reported in an adult following liver laceration repair. Since patients with bronchobiliary fistula usually have poor lung condition preoperatively, perioperative respiratory management and intraoperative double-lumen tube insertion assists in the management of these patients.

Bronchobiliary fistula evaluated with magnetic resonance imaging

Bronchobiliary fistula (BBF) is a rare disorder consisting of a passageway between the biliary ducts and the bronchial tree. Many conditions may give rise to this development. Management of these fistulas is often difficult and can be associated with high morbidity and mortality rates. We present a case of BBF developing after hemihepatectomy in a 74-year-old man treated with endoscopic biliary drainage and illustrate MRCP findings.

A case of bronchobiliary fistula associated with subdiaphragmatic abscess after hepatic surgery

A case of bronchobiliary fistula associated with subdiaphragmatic abscess after hepatic surgery

A Case of Bronchobiliary Fistula in the Setting of Adult Polycystic Kidney and Liver Disease, with a Review of the Literature

A case of bronchobiliary fistula (BBF) was demonstrated in the setting of polycystic kidney and liver disease (PCKLD) by hepatobiliary scintigraphy. High-resolution noncontrast computed tomography through the liver showed a polycystic liver. A calcified cyst adjacent to the dome of the liver appeared to have a fistulous connection with the lung on coronal reconstructions. Hepatobiliary scan confirmed the fistulous connection. In a review of the literature, BBF has been associated with hydatid cyst disease, trauma, postsurgical states, and malignancy. As demonstrated by this case, BBF is difficult to diagnose and requires a high clinical index of suspicion. Hepatobiliary scintigraphy is the imaging modality of choice to confirm BBF, and PCKLD should be added to the list of antecedent etiologies.

Thoracobiliary Fistula

Thoracobiliary communications in the form of either pleurobiliary or bronchobiliary fistulas are reported complications of many diseases. A strong suspicion in the appropriate clinical setting is necessary to recognize this problem. Bilioptysis is the sine qua non of a bronchobiliary fistula. Diagnostic imaging studies are useful to identify the communication and to delineate its location. Although surgery is the optimal intervention, percutaneous drainage and intravenous antimicrobial therapy may offer the best therapeutic option in patients with metastatic cancer and limited physiologic reserve. We report a unique case of bronchobiliary fistula complicating a uterine leiomyosarcoma with hepatic metastases. Long-term palliation was achieved with percutaneous drainage and appropriate fluid and electrolyte replacement therapy.

Demonstration of a bronchobiliary fistula by 99mTc-HIDA cholescintigraphy

A case of bronchobiliary fistula diagnosed by 99mTc-HIDA cholescintigraphy is presented. The fistula caused by a stenosing tumor of the left hepatic duct would probably have been missed without the use of delayed views and body fluids counting which increased the specificity of scintigraphic findings.

Bronchobiliary Fistula Secondary to Amebic Liver Abscess

A case of bronchobiliary fistula with biliptysis complicating amebic liver abscess, is described. The patient recovered on conservative treatment.

Bronchobiliary Fistula Due to Bacteroides

Summary We have described a patient with a 4-year history of recurrent pneumonitis and subcutaneous abscesses, who developed a bronchobiliary fistula with expectoration of bile, and a progressive chemical pneumonia. Surgery was done to divert the fistulous tract and the infection was eventually found to be due to a Bacteroides species, Spherophorous necrophorus . This is the first reported case of bronchobiliary fistula due to this organism.