Bronchobiliary fistula (BBF), which often presents with bilioptysis, is an abnormal communication between the bronchial system and biliary tree. It is a complication associated with a high mortality rate and requires a well-planned management strategy. Although hydatid disease is still the leading cause, extensive surgical interventions and invasive procedures of the liver have altered the profile of patients in recent decades. This paper presents 3 cases of BBF and reviews the literature regarding the treatment options generally mandated by clinical presentation and the underlying disease.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2217537PMC
http://dx.doi.org/10.1186/1749-8090-2-52DOI Listing

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Late onset of biliobronchial fistula - a serious complication of hemihepatectomy for atrophic liver with hepatolithiasis: a case report and review of the literature.

J Cardiothorac Surg

December 2024

Department of Radiology, Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, Hangzhou, 310006, China.

Background: Acquired bronchobiliary fistula (BBF) is a rare but life-threatening complication that can occur as a result of oncological processes, inflammatory reactions, parasite infections, thoracoabdominal trauma, or invasive procedures associated with iatrogenic injury. However, the potential etiology of BBF caused by instrumental issues when using ultrasonic scalpels resulting in diathermy burn and its post-burn effects has never been reported.

Case Presentation: Herein, we present a case of a 65-year-old woman who developed BBF one month after hepatectomy and presented with refractory irritating cough accompanied by yellow bitter sputum.

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Bronchobiliary fistula (BBF) is one of the most exceptional complications following hepatic surgery. By integrating evidence-based case studies from existing literature, this review offers critical insights into the efficacy of diverse imaging modalities and therapeutic approaches across a broad spectrum of clinical scenarios. Computed tomography, and magnetic resonance cholangiography or even scintigraphy shows an abnormal tractus between biliary ducts and pulmonary bronchi and minimally invasive techniques using endoscopy are considered the techniques of choice.

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Article Synopsis
  • Bronchobiliary fistula (BBF) is a rare condition in adults that connects the bronchial system and biliary tract, often resulting from trauma, infections, or surgical complications.
  • The case presented involves a 58-year-old man who developed BBF after liver hydatid cyst surgery, leading to acute breathing issues and requiring multiple diagnostic procedures before surgery.
  • Surgical treatment posed significant challenges for anesthetic management due to factors like potential sepsis and lung isolation difficulties, necessitating a team approach for postoperative care, including respiratory support and antibiotic treatment.
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