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Thoracobiliary fistula

M M Johnson1, R Chin, E F Haponik

  • 1Department of Medicine, Bowman Gray School of Medicine, Winston-Salem, NC 27157-1054, USA.

Southern Medical Journal
|March 1, 1996
PubMed
Summary
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Thoracobiliary fistulas, such as bronchobiliary fistulas, are rare complications. This case highlights long-term palliation of a uterine leiomyosarcoma with hepatic metastases using percutaneous drainage.

Area of Science:

  • Hepatology
  • Thoracic Surgery
  • Gynecologic Oncology

Background:

  • Thoracobiliary communications, including pleurobiliary and bronchobiliary fistulas, are infrequent complications across various pathologies.
  • Recognizing these fistulas requires a high index of suspicion within a relevant clinical context.

Observation:

  • Bilioptysis, the expectoration of bile, is a definitive sign of a bronchobiliary fistula.
  • Diagnostic imaging plays a crucial role in identifying the fistula's presence and precise location.

Findings:

  • A unique case of a bronchobiliary fistula complicating uterine leiomyosarcoma with hepatic metastases is presented.
  • Percutaneous drainage, fluid, and electrolyte replacement therapy provided long-term palliation.

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Implications:

  • While surgery is typically optimal, percutaneous drainage offers a viable therapeutic alternative for patients with metastatic cancer and compromised physiological reserves.
  • This approach can achieve significant palliation in complex cases, improving patient outcomes.