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Congenital tracheobiliary fistula
N Tommasoni1, P G Gamba, P Midrio
1Division of Pediatric Surgery, Department of Pediatrics, University of Padua, Padua, Italy. tommasoni@yahoo.it
Insights
Congenital respiratory tract-biliary fistulas are rare. Surgical excision offers a long-term solution, with bronchoscopy aiding early diagnosis of these rare developmental anomalies.
Area of Science:
- Medical Science
- Pediatric Surgery
- Developmental Biology
Background:
- Congenital respiratory tract-biliary fistulas, encompassing tracheo- and broncho-biliary fistulae, represent exceedingly rare developmental anomalies.
- The existing literature documents only 18 previously reported cases.
Observation:
- Two new cases of congenital respiratory tract-biliary fistula were identified after prolonged diagnostic challenges.
- Both pediatric patients presented with symptoms indicative of this rare anomaly.
Findings:
- Surgical excision of the abnormal tract was performed in both cases.
- Following surgical intervention, both children have remained asymptomatic for 6 and 4 years, respectively, indicating successful treatment.
- Bronchoscopy emerged as a valuable tool for early diagnosis.
Implications:
- Early diagnosis through bronchoscopy is crucial for managing congenital respiratory tract-biliary fistulas.
- Comprehensive investigation for associated biliary tree malformations is essential in patients diagnosed with these fistulas.
- Surgical management appears to provide a durable, symptom-free outcome for affected children.
Abstract:
Congenital respiratory tract-biliary fistula, including tracheo- and broncho-biliary fistulae, are rare developmental anomalies. To date, only 18 cases have been reported. We present two additional cases that came to our attention after a long and difficult attempt to make a diagnosis. After surgical excision of the tract both children have remained symptom-free for 6 and 4 years, respectively. Bronchoscopy allows an early diagnosis, but patients also have to be investigated for associated biliary tree malformations.