RESUMO
Bronchobiliary fistula (BBF) is a rare, highly morbid condition that results from an abnormal connection between biliary channels and the bronchial tree. In the past, this condition has been known to be caused by untreated hydatid cysts or hepatic abscesses that can erode through the diaphragm into the pleural cavity and bronchial tree, creating fistulation. However, the condition's spectrum has changed in recent years, and BBFs have also become associated with neoplasm, iatrogenic causes, and trauma. Cases of BBF are treated differently, either with simple conservative management or invasive surgery. We present a case of a 46-year-old male initially presenting with sepsis, who was found to have a BBF. The diagnosis was made after a hepatobiliary iminodiacetic acid scan showed the flow of a tracer in the lung fields. The condition was likely due to acute cholecystitis and prior biliary instrumentation. The patient was treated successfully with percutaneous cholecystostomy tube insertion followed by elective laparoscopic cholecystectomy several weeks after hospital discharge.
RESUMO
Cutaneous squamous cell carcinoma-keratoacanthoma (cSCC-KA) is a benign but aggressive neoplasm arising from keratinizing epidermal cells. In this case, we report a 56-year-old man who developed a KA on the right second toe after experiencing a minor trauma to the same region, without osteolysis or nodal invasion. Second toe amputation was performed under sedation. Our case highlights the features of cSCC-KA, its association with trauma, and the importance of early diagnosis and treatment.