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

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

• Lee SH
• Lee KJ
• Kim SY
• Lee SK
• Jung KS
• Park BH
• Jung JY
• Son JY
• Yoon YW
• Kang YA
• Park MS
• Kim YS
• Chang J
• Kim SK
• Moon JW

Abstract

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.

Keyword

Cyst, Hepatic; Bronchobiliary fistula; Bilioptysis; Sclerosing injections

MeSH Terms

Aged
Anti-Bacterial Agents
Catheters
Constriction, Pathologic
Drainage
Female
Fistula
Humans
Lithiasis
Liver
Sclerosing Solutions
Sclerosis
Thorax
Anti-Bacterial Agents
Sclerosing Solutions

Figure

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  Figure 1 This picture shows bile-stained sputum.

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

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

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

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

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