Tuberc Respir Dis.  2012 Feb;72(2):228-231.

A Case of Bronchobiliary Fistula as a Complication of Radiofrequency Ablation

• Lee JH
• Kim MS
• Lee JG
• Kim DS
• Yang HJ
• Cho DH
• Kang KW

Abstract

Bronchobiliary fistula (BBF), defined as an abnormal communication between the biliary duct and bronchial trees, is a very rare condition. Bilioptysis is a pathognomonic finding for BBF. We studied a 58-year-old man, who had a BBF complicated by liver biloma that occurred after radiofrequency ablation. The diagnosis was confirmed by the presence of bile-stained sputum and an Endoscopic Retrograde Cholangio-Pancreatography. BBF was treated successfully by endoscopic sphincterotomy and biliary drainage with insertion of a double pig-tail plastic stent into the biloma. We suggest that the optimal choice of treatment modality for BBF depends on the natural course of the underlying disease, and the status of the biliary stricture.

Keyword

Bronchial Fistula; Biliary Fistula; Catheter Ablation

MeSH Terms

Biliary Fistula
Bronchial Fistula
Catheter Ablation
Constriction, Pathologic
Drainage
Fistula
Humans
Liver
Middle Aged
Plastics
Sphincterotomy, Endoscopic
Sputum
Stents
Plastics

Figure

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  Figure 1 Bronchial washing findings. Bile-stained sputum.

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  Figure 2 (A) Chest X-ray showing pneumonic infiltration on the right lower lobe. (B) Chest CT showing ground grass opacity and focal consolidation on the right lower lobe. CT: computed tomograrphy.

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  Figure 3 (A) Coronal reconstruction of the liver enhanced MRI, showing subcapsular fluid collection communicating with the right bronchial tree. (B) ERCP showing hydatid cyst and a fistulous communication (white arrow) with the right bronchial tree. Bile duct stenosis (black arrow) seen between hydatid cyst and common bile duct. MRI: magnetic resonance imaging; ERCP: endoscopic retrograde cholangio-pancreatography.

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  Figure 4 Successful insertion of pig-tail catheter to resolve the bile duct.

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