Acquired Bronchobiliary Fistula After a Living Donor Liver Transplant: A Unique Diagnostic and Therapeutic Challenge

Bronchobiliary fistula (BBF) is an atypical passageway between the biliary system and the bronchial tree. There are scarce reports of BBF and even fewer in living donor liver transplant (LDLT) recipients. We present a case of BBF in a 36-year-old woman who developed a bilious cough 2 years after a LDLT that was complicated by a late bile leak. We conclude that BBF should be considered in LDLT recipients who develop a bile leak postoperatively, given this common risk factor among reviewed cases. We support the use of hepatobiliary scintigraphy for diagnosis and noninvasive approaches aimed at decompression for repair.