ABSTRACT
INTRODUCTION: Bronchobiliary fistulas are rare and difficult to treat. Peacock first reported this entity in 1850 while treating a patient with hepatic encopresis. CASE PRESENTATION: A 67-year-old Chinese male patient presented to the outpatient clinic with a complaint of coughing up phlegm with chest tightness for 4 days with symptoms of intermittent bilirubin sputum with a sputum volume of about 500 ml per day but no symptoms of abdominal pain or jaundice and no yellow urine or steatorrhea. The examination revealed cyanosis of the lips and mouth, barrel chest, low breath sounds on the right side, and a large number of wet rales heard in both lungs. The imaging investigations were suggestive of bronchobiliary fistula. Therefore, the patient was operated on and discharged with no perioperative complications. CONCLUSION: Bronchobiliary fistula should be considered diagnostically in patients with known liver disease who also experience trauma or medical treatment and cough up bile-colored sputum, regardless of the presence of concurrent infections, and in conjunction with radiological expertise to identify it. Here, we report a case of bronchobiliary fistula and a brief review of the literature on it.
Subject(s)
Biliary Fistula , Bronchial Fistula , Liver , Humans , Male , Bronchial Fistula/diagnostic imaging , Bronchial Fistula/etiology , Bronchial Fistula/diagnosis , Biliary Fistula/diagnosis , Biliary Fistula/surgery , Aged , Liver/diagnostic imaging , Liver/injuries , Rupture , Tomography, X-Ray ComputedSubject(s)
Bronchial Fistula , Pleural Diseases , Subcutaneous Emphysema , Humans , Bronchial Fistula/etiology , Bronchial Fistula/diagnostic imaging , Invasive Pulmonary Aspergillosis/complications , Invasive Pulmonary Aspergillosis/diagnostic imaging , Pleura/pathology , Pleural Diseases/complications , Pleural Diseases/diagnostic imaging , Respiratory Tract Fistula/etiology , Respiratory Tract Fistula/complications , Respiratory Tract Fistula/diagnostic imaging , Subcutaneous Emphysema/etiology , Subcutaneous Emphysema/diagnostic imaging , Tomography, X-Ray Computed , Female , AdultABSTRACT
Bronchopleural fistula (BPF) is a potentially fatal complication and remains a surgical challenge. Concomitant problems, such as pulmonary infection and respiratory failure, are typically the main contributors to mortality from BPF because of improper contact between the bronchial and pleural cavity. We present the case of a 75-year-old male patient with a history of right upper lobe lung cancer resection who developed complex BPFs. Following appropriate antibiotic therapy and chest tube drainage, we treated the fistulas using endobronchial valve EBV placement and local argon gas spray stimulation. Bronchoscopic treatment is the preferred method for patients who cannot tolerate a second surgery because it can help to maximize their quality of life. Our treatment method may be a useful reference for treating complex BPF.
Subject(s)
Bronchial Fistula , Pleural Diseases , Male , Humans , Aged , Quality of Life , Bronchoscopy/adverse effects , Bronchial Fistula/diagnostic imaging , Bronchial Fistula/etiology , Bronchial Fistula/surgery , Pleural Diseases/diagnostic imaging , Pleural Diseases/etiology , Pleural Diseases/surgery , Anti-Bacterial Agents/therapeutic useABSTRACT
Bronchobiliary fistulas are defined as an abnormal communication between the biliary system and the bronchial tree. They are extremely rare complications of radiofrequency or microwave ablation. A 39-year-old woman with a history of neuroendocrine pancreatic carcinoma suffering from liver metastasis was treated with microwave ablation (MWA). In this case report, we present a case of intractable biliptysis from a bronchobiliary fistula secondary to an MWA. The patient was diagnosed by endoscopic retrograde cholangiopancreatograph and hepatobiliary scintigraphy. Treatment involved a right hemihepatectomy, a redo-hepaticojejunostomy, and the surgical placement of a transhepatic drain. After 6 weeks of drain placement, this could be removed. The fistula was thus successfully treated.
Subject(s)
Biliary Fistula , Bronchial Fistula , Liver Neoplasms , Humans , Female , Biliary Fistula/etiology , Biliary Fistula/diagnostic imaging , Biliary Fistula/surgery , Bronchial Fistula/etiology , Bronchial Fistula/diagnostic imaging , Adult , Liver Neoplasms/secondary , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/surgery , Treatment Outcome , Microwaves/therapeutic use , Microwaves/adverse effects , Hepatectomy , Drainage , Pancreatic Neoplasms/secondary , Pancreatic Neoplasms/surgery , Pancreatic Neoplasms/diagnostic imaging , Pancreatic Neoplasms/pathologyABSTRACT
BACKGROUND: Broncho-esophageal fistula (BEF) secondary to esophageal diverticulum is a rare clinical condition, which is often misdiagnosed for a long time. The aim of our study is to summarize and clarify the advantages of MSCT in diagnosing BEF secondary to esophageal diverticulum. METHODS: We retrospectively analyzed patients clinically diagnosed with BEF from January 2005 to January 2022 at Jilin University First Hospital. Only those patients with BEF secondary to esophageal diverticulum and complete clinical data met our enrolled standard. All patients' clinicopathologic characteristics and MSCT features were systemically evaluated. RESULTS: 17 patients were eligible for our cohort study, including male 10 and female 7. The patient's mean age was 42.3 ± 12.5. The chronic cough occurred in all seventeen patients and bucking following oral fluid intake was documented in nine patients. MSCT distinctly suggested the fistulous tract between the bronchi and the esophagus in all patients. The mean diameter of the orifices in the wall of the esophagus was 4.40 ± 1.81 mm. The orifice in the midthoracic esophagus side was 15 cases and 2 cases at the lower thoracic esophagus. The involved bronchus included 13 cases at the right lower lobe bronchus, 1 at the right middle lobe bronchus and 3 at the left lower lobe bronchus. The contrast agent was observed in the pulmonary parenchyma in 10 of 13 patients who underwent esophagogram. No definite fistula was observed in 3 of 11 who underwent gastroscopy, while the intra-operative findings supported the existence of fistula. CONCLUSIONS: BEF secondary to esophageal diverticulum tends to occur between the midthoracic esophagus and the right lower lobe bronchus. Compared with esophagography and gastroscopy, MSCT shows more comprehensive information about the fistulous shape, size, course and lung involvement, which are helpful for establishing diagnosis and guiding subsequent treatment.
Subject(s)
Bronchial Fistula , Diverticulum, Esophageal , Esophageal Fistula , Adult , Humans , Male , Female , Middle Aged , Retrospective Studies , Cohort Studies , Diverticulum, Esophageal/diagnosis , Diverticulum, Esophageal/diagnostic imaging , Esophageal Fistula/diagnostic imaging , Esophageal Fistula/etiology , Bronchial Fistula/diagnostic imaging , Bronchial Fistula/etiology , Bronchial Fistula/surgerySubject(s)
Bronchial Fistula , Empyema, Pleural , Lung Abscess , Pleural Diseases , Ultrasonography , Humans , Male , Bronchial Fistula/diagnostic imaging , Bronchial Fistula/complications , Empyema, Pleural/diagnostic imaging , Lung Abscess/diagnostic imaging , Lung Abscess/complications , Pleural Diseases/diagnostic imaging , Pleural Diseases/complications , Point-of-Care Systems , Point-of-Care Testing , Ultrasonography/methods , AdultABSTRACT
We present a 19-year-old woman, a case of Lemierre syndrome, who presented with fever, sore throat, and left shoulder pain. Imaging revealed a thrombus in the right internal jugular vein, multiple nodular shadows below both pleura with some cavitations, right lung necrotizing pneumonia, pyothorax, abscess in the infraspinatus muscle, and multiloculated fluid collections in the left hip joint. After inserting a chest tube and administering urokinase for the pyothorax, a bronchopleural fistula was suspected. The fistula was identified based on clinical symptoms and computed tomography scan findings. If a bronchopleural fistula is present, thoracic lavage should not be performed as it may cause complications such as contralateral pneumonia due to reflux.
Subject(s)
Bronchial Fistula , Empyema, Pleural , Lemierre Syndrome , Pleural Diseases , Pneumonia , Female , Humans , Young Adult , Adult , Lemierre Syndrome/complications , Lemierre Syndrome/diagnosis , Bronchial Fistula/complications , Bronchial Fistula/diagnostic imaging , Pleural Diseases/complications , Pleural Diseases/diagnostic imaging , Empyema, Pleural/complications , Empyema, Pleural/diagnostic imagingSubject(s)
Bronchial Fistula , Mycobacterium abscessus , Humans , Mycobacterium abscessus/drug effects , Mycobacterium abscessus/isolation & purification , Bronchial Fistula/therapy , Bronchial Fistula/diagnostic imaging , Male , Mycobacterium Infections, Nontuberculous/drug therapy , Pleural Diseases/therapy , Middle Aged , Drugs, Chinese Herbal/therapeutic use , Medicine, Chinese TraditionalABSTRACT
Coronary fistulas are unusual finding in coronary angiography (CAG) with coronary bronchial fistula (CBF) being a rarer one. Here, we represent a case of CBF which was diagnosed incidentally on CAG. These anomalous connections can be percutaneously treated.
Subject(s)
Bronchial Fistula , Coronary Artery Disease , Coronary Vessel Anomalies , Humans , Bronchial Fistula/diagnostic imaging , Bronchial Fistula/etiology , Bronchial Fistula/surgery , Incidental Findings , Coronary Vessel Anomalies/complications , Coronary Vessel Anomalies/diagnostic imaging , Coronary AngiographySubject(s)
Bronchial Fistula , Lung Abscess , Pleural Diseases , Humans , Lung Abscess/complications , Lung Abscess/diagnostic imaging , Lung Abscess/surgery , Bronchial Fistula/diagnostic imaging , Bronchial Fistula/etiology , Bronchial Fistula/surgery , Pleural Diseases/complications , Pleural Diseases/diagnostic imaging , Pleural Diseases/surgery , Lung , PneumonectomySubject(s)
Aortic Diseases , Bronchial Fistula , Fistula , Vascular Fistula , Humans , Aortic Diseases/diagnostic imaging , Aortic Diseases/surgery , Vascular Fistula/diagnostic imaging , Vascular Fistula/surgery , Bronchial Fistula/diagnostic imaging , Bronchial Fistula/etiology , Bronchial Fistula/surgery , Hemoptysis , Aorta, Thoracic/diagnostic imagingABSTRACT
BACKGROUND: Pleuropulmonary amebiasis is the second most common form of extraintestinal invasive amebiasis, but cases that include bronchopleural fistula are rare. CASE PRESENTATION: A 43-year-old male was referred to our hospital for liver abscess, right pleural effusion, and body weight loss. He was diagnosed with a bronchopleural fistula caused by invasive pleuropulmonary amebiasis and human immunodeficiency virus (HIV) infection. After initial medical treatment for HIV infection and invasive amebiasis, he underwent pulmonary resection of the invaded lobe. Intraoperative inspection revealed a fistula of the right basal bronchus in the perforated lung abscess cavity, but the diaphragm was intact. The patient was discharged on postoperative day 3 and was in good condition at the 1-year follow-up. CONCLUSIONS: Clinicians should be aware that pleuropulmonary amebiasis can cause a bronchopleural fistula although it is very rare.