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Bronchobiliary fistulae due to echinococcosis
M Gerazounis1, Kalliopi Athanassiadi, E Metaxas
1Department of Thoracic Surgery, General Hospital of Nikea - Piraeus, Hellas, Konstantinoupoleosstrasse 34A, 15562 Holargos, Athens, Greece.
Summary
Bronchobiliary fistula (BBF) is a rare but dangerous complication of echinococcosis. Surgical intervention involving cyst evacuation and fistula closure demonstrated effective treatment with no recurrence in a 7-12 year follow-up.
Area of Science:
- Hepatobiliary Surgery
- Thoracic Surgery
- Infectious Diseases
Background:
- Bronchobiliary fistula (BBF) is a rare complication of hepatic echinococcosis, resulting from hydatid cyst rupture into the bronchial tree.
- This entity presents with symptoms such as dyspnea, cough, biloptysis, and fever, posing significant clinical challenges.
Purpose of the Study:
- To present the experience in treating bronchobiliary fistula (BBF) secondary to echinococcosis.
- To highlight the diagnostic and management strategies for this uncommon complication.
Main Methods:
- A retrospective review of 21 patients treated for BBF over 20 years.
- Diagnostic imaging was utilized to identify fistula location and extent.
- Surgical management involved cyst evacuation, obliteration, lung freeing, and fistula closure via right thoracotomy.
Main Results:
- Right thoracotomy was the preferred surgical approach.
- Two deaths occurred, attributed to anaphylactic shock and cardiac insufficiency.
- Long-term follow-up (7-12 years) showed no recurrence of BBF.
Conclusions:
- Bronchobiliary fistula remains a serious complication of echinococcosis with high morbidity and mortality.
- Early diagnosis and prompt management of associated septic complications are crucial for favorable outcomes.