Abstract
Bronchobiliary fistula is a rare and is an uncommon but severe complication of hydatid disease of the liver. Treatment has traditionally been surgical resection, but embolization and stent placement have been described. The invasive method seems to be a key component of patient treatment. We describe a case of a 58-year-old woman who, 25 years before, had undergone surgery for a hydatid cyst. A total cystectomy without previous puncture or parasite extraction was carried out. The lower aspect of the cyst was found to be completely perforated over the biliary duct. During the postoperative course, the patient had subphrenic right-sided pleural effusion and biliary fistula that subsided with medical treatment. Afterward, the patient came to the outpatient area of our hospital complaining of leakage of purulent exudate through the cutaneous opening, pain located on the right hypochondrium radiating to the right hemithorax, malaise, fever, chronic cough, and occasional vomiting of bile. Fistulography revealed an anfractuous cavity communicating with a residual cystic cavity on the right hepatic lobe. We observed communication with the intrahepatic canaliculi. Computed tomographic scan revealed a fistulous tract on the anterior liver border through the abdominal wall. There were no posttreatment complications. The patient is asymptomatic.
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Tanaka S, Hirohashi K, Tanaka H et al (2002) Incidence and management of bile leakage after hepatic resection for malignant hepatic tumors. J Am Coll Surg 195:484–489
Rose DM, Rose AT, Chapman WC et al (1998) Management of bronchobiliary fistula as a late complication of hepatic resection. Am Surg 64:873–876
Tocchi A, Mazzoni G, Miccini M et al (2007) Treatment of hydatid bronchobiliary fistulas: 30 years of experience. Liver Int 27:209–214
Gourgiotis S, Stratopoulos C, Moustafellos P et al (2007) Surgical techniques and treatment for hepatic hydatid cysts. Surg Today 37:389–395
Hibi T, Sakamoto Y, Asamura H et al (2007) Successful resection of hepatocellular carcinoma with bronchobiliary fistula caused by repeated transcatheter arterial embolizations: report of a case. Surg Today 37:154–158
Tierris EJ, Avgeropoulos K, Kourtis K, Papaevangelou EJ (1977) Bronchobiliary fistula due to echinococcosis of the liver. World J Surg 1:99–104
Pomeranz S, Constantini S, Umansky F (1991) The use of fibrin sealant in cerebrospinal fluid leakage. Neurochirurgia (Stuttg) 34:166–169
Thanos L, Mylona S, Brontzakis P et al (2008) A complicated postsurgical echinococcal cyst treated with radiofrequency ablation. Cardiovasc Intervent Radiol 31:215–218
Grande D, Ruiz JC, Elizagaray E et al (1990) Hepatic echinococcosis complicated with transphrenic migration and bronchial fistula: CT demonstration. Gastrointest Radiol Spring 15:115–118
Kabiri H, Chafik A, Al Aziz S et al (2000) Treatment of hydatid bronchial and bilio-pleurobronchial fistulas via thoracotomy. Ann Chirurg 125:654–659
Akhan O, Gumus B, Akinci D et al (2007) Diagnosis and percutaneous treatment of soft-tissue hydatid cysts. Cardiovasc Intervent Radiol 30:419–425
Jung S, Goo JM, Han JK et al (2003) Recurrent bronchobiliary fistula: unsuccessful management with repeated insertion of metallic biliary stent. J Vasc Interv Radiol 14:1577–1579
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Prieto-Nieto, M.I., Pérez-Robledo, J.P., Álvarez-Luque, A. et al. Cutaneous Bronchobiliary Fistula Treated with Tissucol Sealant. Cardiovasc Intervent Radiol 34 (Suppl 2), 232–235 (2011). https://doi.org/10.1007/s00270-010-9807-0
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DOI: https://doi.org/10.1007/s00270-010-9807-0