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Bronchobiliary fistula: complete percutaneous treatment with biliary drainage and stricture dilation
M L Schwartz1, M J Coyle, J S Aldrete
1Department of Diagnostic Radiology, University of Alabama, Birmingham School of Medicine 35233.
Insights
A minimally invasive procedure successfully treated a rare bronchobiliary fistula and common hepatic duct stricture in a young adult following liver surgery. This approach restored normal bile flow, resolving jaundice and cholangitis.
Area of Science:
- Gastroenterology and Hepatology
- Interventional Radiology
Background:
- Post-surgical complications after liver resection can include biliary issues.
- Bronchobiliary fistulas are rare but serious complications, potentially leading to cholangitis and jaundice.
Observation:
- An 18-year-old male presented with jaundice and cholangitis 19 months post-right hepatic lobe resection.
- Percutaneous transhepatic cholangiography revealed a bronchobiliary fistula and common hepatic duct stricture.
Findings:
- Percutaneous therapy involved biliary drainage and balloon dilation cholangioplasty.
- The intervention successfully eradicated the bronchobiliary fistula.
- Normal bile flow was reestablished, resolving the patient's symptoms.
Implications:
- Percutaneous transhepatic cholangiography is a valuable diagnostic and therapeutic tool for complex post-surgical biliary complications.
- Minimally invasive interventions can effectively manage rare conditions like bronchobiliary fistulas.
- Successful treatment can prevent long-term morbidity associated with untreated biliary strictures and fistulas.
Abstract:
Percutaneous transhepatic cholangiography was performed on an 18-year-old man who presented with jaundice and cholangitis 19 months after right hepatic lobe resection. The cholangiogram demonstrated a bronchobiliary fistula and a stricture of the common hepatic duct. Percutaneous therapy consisting of biliary drainage and balloon dilation cholangioplasty was successful in eradicating the fistula and reestablishing normal bile flow.