Successful treatment of bronchobiliary fistula via interventional occlusion with vascular plugs

A 61-year-old man with a history of hepatocellular carcinoma (HCC), who had undergone hepatic resection and cholecystectomy 2 years earlier, followed by sequential transcatheter arterial chemoembolization (TACE) for recurrent HCC 1 year ago, presented with a 1-month history of bilioptysis, cough, and abdominal distension. Bronchoscopy identified bile-like discharge expelled from the right middle lobe bronchus during coughing, confirming the diagnosis of bronchobiliary fistula. Successful treatment was achieved via deployment of the Amplazter Vascular Plugs (AVP Ⅱ) at the fistula site under fluoroscopy guidance.