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Caso de bilioptisis después de la extirpación del quiste hidatídeo
Robin B Poovattil1, Roman Dutta1, Abhishek Mohan1
1Sir Ganga Ram Hospital, New Delhi, India.
Indian journal of thoracic and cardiovascular surgery
|August 27, 2025
Resumen
La bilioptisis, la bilis en el esputo de una fístula biliobronquial, requiere un diagnóstico y tratamiento rápidos. Este caso destaca el manejo quirúrgico y endoscópico exitoso de una fístula biliobronquial compleja después del tratamiento del quiste hidatado hepático.
Área de la Ciencia:
- Gastroenterología y Hepatología
- Pulmonología
- Innovación quirúrgica
Sus antecedentes:
- La fístula biliobronquial es una condición rara y de alta morbilidad que une el árbol biliar y los bronquios.
- El diagnóstico y el tratamiento tempranos son críticos debido a las altas tasas de mortalidad asociadas.
- Este caso involucra a un paciente con antecedentes de quiste hidatídeo hepático tratado.
Objetivo del estudio:
- Para presentar un caso de bilioptisis causado por una fístula biliobronquial.
- Para resaltar los desafíos diagnósticos y terapéuticos y el manejo exitoso de esta condición rara.
Principales métodos:
- Hombre de 46 años con antecedentes de quiste hidatídeo hepático tratado presentado con bilioptisis.
- Las imágenes (tomografía computarizada) confirmaron una fístula biliobronquial secundaria a una recolección subdiafragmática y una rotura diafragmática.
- El tratamiento incluyó la extirpación quirúrgica de la fístula y los segmentos pulmonares afectados, la reparación diafragmática y la colangiopancreatografía endoscópica retrógrada (ERCP) con stenting.
Principales resultados:
- La bilioptisis del paciente se resolvió completamente después de la intervención quirúrgica y endoscópica combinadas.
- La fístula fue identificada y extirpada con guía de broncoscopia intraoperatoria.
- El control de la fuente se logró a través de ERCP y stenting.
Conclusiones:
- La fístula biliobronquial requiere un enfoque multidisciplinario para un manejo exitoso.
- La intervención quirúrgica combinada con ERCP y stenting puede tratar eficazmente los casos complejos de bilioptisis.
- El diagnóstico precoz y la intervención oportuna son fundamentales para mejorar los resultados en pacientes con fístula biliobronquial.
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