Acquired Bronchobiliary Fistula in a Young Adult Patient With Sepsis: A Case Report.

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.

Squamous Cell Carcinoma of the Toe Secondary to a Traumatic Injury.

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.

Pelvic Hematoma With Acute Hemorrhage Secondary to Inferior Vena Cava Filters.

Recurrent deep vein thrombosis (DVT) and inferior vena cava (IVC) thrombosis are well-known complications of inferior vena cava filters (IVCFs); however, pelvic hematoma is a rare finding. In this study, we present a case of a 41-year-old female who presented with severe abdominal pain. Extensive bilateral lower extremity DVT, thrombosis extending up to the level of IVCF, and a pelvic hematoma with acute hemorrhage were diagnosed. Mechanical thrombectomy of the IVC, bilateral iliac, and femoral veins with stent placement in the external iliac veins was performed under general anesthesia. This rarely reported case remains a challenge to diagnose and treat because of its complex mechanisms and multiple risk factors. Our case highlights the importance of the surgical strategy adopted and the need for a good initial assessment.