Hepatopulmonary fistula: treatment with biliary metallic endoprosthesis

Hepatopulmonary communication, most commonly in the form of bronchobiliary fistula, is an unusual lesion that can occasionally close spontaneously, but usually requires surgical therapy. The usual treatment has been a combined thoracoabdominal approach with correction of the fistulous tract or an abdominal approach to correct the causative bile duct obstruction. Both endoscopic and percutaneous therapy of the biliary ductal system have been described as forms of treatment. We present a case of hepatopulmonary fistula in a patient with bilioptysis, treated with percutaneous biliary metallic endoprosthesis. To our knowledge, this is the first reported case in which metallic stents were used to treat a hepatopulmonary fistula.