, Volume 47, Issue 2, pp 141-142
Date: 21 Nov 2012

Diagnosis of Bronchobiliary Fistula—Utility of 99 m Tc-Mebrofenin Scan and SPECT/CT

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A broncho-biliary fistula (BBF) is difficult to diagnose in the absence of biliptysis. We present here the case of a 3-year-old female child who developed a BBF that was diagnosed on a 99mTc-Mebrofenin hepatobiliary (HIDA) scan. In this case, the cause was due to a complicated amoebic liver abscess that progressively ruptured through the right pleural space. We have also demonstrated tracer accumulation in the posterobasal part of the right lung along with consolidation, which is direct evidence that bile is accumulating in the lung on single-photon emission computed tomography/X ray computed tomography (SPECT/CT) (Figs. 1 and 2).Fig. 1

A,1B: A 3-year-old child, with a history of ruptured amoebic liver abscess 7 months ago, presented with abdominal distension, cough and vomiting for the last 2 days. Bronchoscopy revealed bilious stained oozing; hence, there was a clinical suspicion of bronchobiliary fistula (BBF). Serial dynamic and static images of 99mTc-mebrofenin hepatobiliary scinti