Fístula broncobiliar congénita: Caso dínico / Congenital broncho-biliary fistula: A case report

La fístula traqueo- o broncobiliar congénita o fístula hepatopulmonar congénita es una rara malformación con alta morbimortalidad si su diagnóstico no se realiza a tiempo. Existe una comunicación entre el sistema respiratorio (tráquea o bronquio) y el tracto biliar. Hasta la fecha, se han reportado solo 35 casos. Presentamos el caso de un neonato con neumopatía derecha y débito bilioso por el tubo endotraqueal. El diagnóstico se realizó mediante broncoscopía con radioscopía y la resección de la fístula broncobiliar fue por videotorascopía. Posteriormente, se requirió de una hepatectomía izquierda con anastomosis biliodigestiva en Y de Roux por presentar hipoplasia de colédoco.

Congenital tracheo-or-bronchobiliary fistula or congenital he-patopulmonary fistula is a rare malformation with high morbidity and mortality if the diagnosis is not made early. The tracheo-or-bronchobiliary fistula is a communication between the respiratory (trachea or bronchus) and biliary tract. To date, only 35 cases have been published worldwide. We report a case of a neonate with right pneumonia and bilious fluid in the endotracheal tube. Diagnosis was made using bronchoscopy with fluoroscopy. Videothoracoscopy was used to remove the bronchobiliary fistula. Subsequently, a left he-patectomy with Roux-en-Y biliary-digestive anastomosis was performed as bile ductus hypoplasia was present.

Diagnosis and management of abdominal collection of biliary fluid postoperative biliary surgery / 临床外科杂志

Objective To sum up the experience of diagnosis and management of postoperative abdominal bile collection of biliary fluid .Methods Analysis of 36 cases admitted in our department with postoperative abdominal biliary fluid collection were studied and treated in our department.Clinically,these cases can be divided into three groups according to their manisfestation,including asymptomatic cases,acute diffuse peritonitis and cases with obscure clinical course.The clinical feature and morbidities of these three groups were compared.Result The morbidities of cases detected collections of biliary fluid and managed in time were significant lower than that of the cases detected and managed out of time.Conclusions Clinically postoperative collection of abdominal biliary fluid might be divided into asymptomatic cases,acute diffuse peritonitis and cases with obscure course by us,it is for the sake of early diagnosis and immediate management.The diagnosis in time and immedate aspiration or drainage will save the patient from adverse morbidities.