Related Experiment Videos

Congenital bronchobiliary fistula in a 65-year-old woman

Hideshi Uramoto1, Osamu Kawano, Mineharu Sugimoto

  • 1Kumamoto Saishunso National Hospital, National Hospital Organization, Kosi.

Internal Medicine (Tokyo, Japan)
|July 17, 2008
PubMed

Insights

Congenital bronchobiliary fistula (CBBF), a rare condition, was incidentally found in a 65-year-old woman. This case represents the oldest reported adult diagnosis of CBBF, likely due to a narrow fistula.

Area of Science:

  • Medical Diagnostics
  • Congenital Malformations
  • Pulmonology
  • Hepatology

Background:

  • Congenital bronchobiliary fistula (CBBF) is a rare congenital anomaly, typically diagnosed in infancy due to respiratory issues.
  • Surgical intervention is the standard treatment for CBBF.
  • Most reported cases occur in neonates and infants, with few adult diagnoses.

Observation:

  • A 65-year-old woman presented with incidental findings of CBBF during investigations for pulmonary nodules.
  • Bronchoscopy revealed an accessory bronchus with bilirubin-rich secretions.
  • Thoracic CT, drip infusion cholangiography, and cholescintigraphy confirmed the airway-biliary tract communication.

Findings:

  • The patient had a narrow congenital bronchobiliary fistula.
  • The narrowness of the fistula is hypothesized to be the reason for the patient's asymptomatic long survival.
  • This case is the fifth reported adult diagnosis and the oldest at 65 years.

Implications:

  • This case expands the known age range for adult diagnosis of CBBF.
  • It highlights the possibility of late diagnosis in adults with CBBF, particularly if the fistula is narrow.
  • Further research into the long-term implications and management of incidentally discovered CBBF in adults is warranted.

Related Concept Videos

Chronic Obstructive Pulmonary Disease III: Chronic Bronchitis Features01:24

Chronic Obstructive Pulmonary Disease III: Chronic Bronchitis Features

Chronic bronchitis is a key phenotype of chronic obstructive pulmonary disease (COPD), characterized by airway-centered inflammation and mucus overproduction. It develops from long-term exposure to harmful particles or gases, most commonly cigarette smoke, which triggers a persistent inflammatory response.Cellular and Structural ChangesInflammation initially affects the large bronchi and later the smaller airways, with infiltration by immune cells, including neutrophils, macrophages, and...
Pneumothorax II: Pathophysiology01:08

Pneumothorax II: Pathophysiology

Pneumothorax means the presence of air in the pleural space — the thin potential gap between the visceral and parietal pleura. This condition disrupts the normal pressure balance that keeps the lungs inflated, leading to partial or complete collapse of the affected lung.Normal physiologyUnder normal conditions, the pleural space maintains a slightly negative intrapleural pressure, which keeps the lungs expanded against the chest wall. This negative pressure creates a delicate balance between...
Pneumothorax-I01:26

Pneumothorax-I

A pneumothorax is a condition where air builds up in the space between the lung and the chest wall, causing the lung to collapse. This condition arises when air enters the space between the parietal and visceral pleura, disrupting the negative pressure essential for lung inflation. This can lead to a partial or complete collapse of the lung.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
Pneumothorax-II01:27

Pneumothorax-II

Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Chronic Obstructive Pulmonary Disease IV: Clinical Manifestations01:19

Chronic Obstructive Pulmonary Disease IV: Clinical Manifestations

Chronic Obstructive Pulmonary Disease, or COPD, is a long-term condition marked by persistent and only partially reversible airflow limitation. It involves two overlapping conditions—chronic bronchitis and emphysema—which often co-appear but differ in dominant symptoms and underlying mechanisms.Chronic Bronchitis FeaturesChronic bronchitis presents with a persistent productive cough and thick, sometimes purulent mucus due to airway inflammation, enlarged mucus glands, and goblet cell...
Chronic Obstructive Pulmonary Disease-II: Pathophysiology01:20

Chronic Obstructive Pulmonary Disease-II: Pathophysiology

Chronic Obstructive Pulmonary Disease (COPD) pathophysiology is intricate and multifaceted, involving a complex interplay of physiological processes. Understanding these mechanisms is crucial for effectively managing and treating COPD. Here is an in-depth look at the critical elements in the pathophysiology of COPD:
Chronic Inflammation