Tuberc Respir Dis.  2010 Aug;69(2):119-123.

Bilioptysis Caused by Bronchobiliary Fistula Secondary to Sclerosing Therapy of Liver Cyst

  • 1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 2The Institute of Chest Diseases, Yonsei University College of Medicine, Seoul, Korea.


Bronchobiliary fistula is a rare disorder consisting of an abnormal communication between the bronchial tree and the biliary duct. In Western countries, trauma, postoperative biliary stenosis, and biliary lithiasis are the predominant causative factors of bronchobiliary fistula. Bilioptysis (bile stained sputum) is a pathognomic finding for bronchobiliary fistula. To date, there are just a few reported cases of bronchobiliary fistula after sclerosis of a liver cyst. We describe the case of a 74-year-old woman who developed bronchobiliary fistula after sclerosing therapy of a liver cyst. The diagnosis was confirmed by the presence of bilioptysis and the chest and dynamic liver CT findings. The patient was successfully treated with antibiotics and percutaneous transhepatic catheter drainage.


Cyst, Hepatic; Bronchobiliary fistula; Bilioptysis; Sclerosing injections

MeSH Terms

Anti-Bacterial Agents
Constriction, Pathologic
Sclerosing Solutions
Anti-Bacterial Agents
Sclerosing Solutions


  • Figure 1 This picture shows bile-stained sputum.

  • Figure 2 The chest X-ray shows consolidation on the right lower lung field.

  • Figure 3 The initial chest CT reveals secondary abscess of lung due to liver cyst infection and diaphragm rupture.

  • Figure 4 (A, B) The liver CT shows extrahepatic biloma and abscess formation with pleural fistula (arrow).

  • Figure 5 The follow-up chest CT reveals an improvement of the previous lung abscess and extrahepatic biloma.


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