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Bronchobiliary fistula in chronic pancreatitis. Case report
S N Genell1, F T Fork, H Jiborn
1Department of Surgery, Malmö General Hospital, Sweden.
Acta Chirurgica Scandinavica
|July 1, 1987
Summary
A rare bronchobiliary fistula developed in a patient with chronic pancreatitis, leading to bilioptysis. Surgical excision of the fistulous tract and revision of a prior biliary bypass were necessary for treatment.
Area of Science:
- Gastroenterology
- Pulmonology
- Surgical Pathology
Background:
- Bronchobiliary fistulas are uncommon complications.
- Biliary obstruction with abscess formation can lead to fistula development.
- Few cases link chronic pancreatitis to bronchobiliary fistulas.
Observation:
- A 47-year-old male with chronic alcohol-induced pancreatitis presented with a hepatic abscess.
- The patient developed bilioptysis (bile in sputum) after failed abscess drainage.
- Imaging confirmed a bronchobiliary fistula, with obstruction of the hepaticoduodenal ligament by pancreatic inflammation.
Findings:
- Percutaneous transhepatic cholangiography (PTC) and bronchography visualized the fistulous tract.
- Surgical excision of the bronchobiliary fistula was performed.
- Portal vein thrombosis and varices complicated the post-operative course, causing gastrointestinal bleeding.
Implications:
- This case highlights a rare presentation of bronchobiliary fistula secondary to chronic pancreatitis.
- Successful surgical management involved fistula excision and revision of biliary-enteric anastomosis.
- Complications such as portal vein thrombosis underscore the complexity of managing such cases.