A Case of Bronchobiliary Fistula Treated by Percutaneous Endobiliary Fistula Closure

Case Report

Austin J Clin Case Rep. 2023; 10(3): 1282.

A Case of Bronchobiliary Fistula Treated by Percutaneous Endobiliary Fistula Closure

Zhang Jian*; Lin Zhipeng; Zou Xugong; Hu Xiaolong; Huang Dabei; Chen Yuan; Li Xiaoqun

Department of Interventonal Medicine, Zhongshan People’s Hospital, Guangdong 528400, China

*Corresponding author: Zhang Jian Department of Interventonal Medicine, Zhongshan People’s Hospital, Guangdong 528400, China. Email: wy18988583838@163.com

Received: April 04, 2023 Accepted: April 29, 2023 Published: May 06, 2023

Abstract

Bronchobiliary fistula is a rare clinical condition with a characteristic clinical presentation of coughing bile-like sputum, which seriously affects the patient’s quality of life. We report a case of a 60-year-old male patient with bronchobiliary fistula who was successfully treated with percutaneous hepatic puncture to closure the endobiliary fistula. The patient was followed up for 3 months without recurrence of bile-like sputum.

Keywords: Bronchobiliary fistula; Interventional therapy; Cholangiocarcinoma

Clinical Information

Male patient, 60 years old, was admitted with "cough and sputum for 1 week and fever for 2 days. The patient had a cough with no obvious cause and yellow bile-like sputum with bitter taste 1 week ago, and fever with a maximum of 39.6°C started 2 days ago. Past history: right hemicolectomy + hepatic caudatectomy + partial resection of hepatic segment 4b + cholecystectomy + left hepatic ductoplasty + left hepatic duct jejunostomy Roux-en-Y anastomosis on April 14, 2021; postoperative pathology: (liver) moderately differentiated intrahepatic cholangiocarcinoma with cancer visible in group 12b lymph nodes (1/1). Postoperative regularity to our hospital for chemotherapy treatment. The MRI examination suggested an encapsulated effusion in the right lobe of the liver with the effusion communicating with the right lower lung; abnormal signal in the head of the pancreas, involving the main pancreatic duct and portal vein, with truncation of the main pancreatic duct, distal pancreatic duct dilatation, and blurred and edematous peripancreatic soft tissue gap, considering tumor recurrence (Figure 1A-D). Fiberoptic bronchoscopy suggested a large amount of bile-like secretion in the right airway (Figure 1E). The secretion sent for examination suggested the presence of bilirubin component. The bronchobiliary fistula was considered to have formed; The symptoms did not improve after symptomatic treatment with internal medicine. After full communication with the patient and family and signing the informed consent form, percutaneous hepatic puncture was performed to closure the endobiliary fistula at an elective date.

Citation: Jian Z, Zhipeng L, Xugong Z, Xiaolong H, Dabei H, et al. A Case of Bronchobiliary Fistula Treated by Percutaneous Endobiliary Fistula Closure. Austin J Clin Case Rep. 2023; 10(3): 1282.