ABSTRACT
INTRODUCTION: Bronchobiliary fistula (BBF) is a pathological communication between the bronchial system and the biliary tree that presents with bilioptysis. Many conditions can cause its development. There is still no optimal therapy for BBF. Conservative treatment is rarely indicated, as was published before in a few cases. CASE REPORT: We presented a 71-year-old Caucasian Serbin woman with BBF secondary to previous laparotomy due to multiple echinococcus liver cysts. The diagnosis was established by the presence of bilirubin and bile acids in sputum and magnetic resonance cholangiopancreatography (MRCP). A repeat MRCP performed after conservative procedure, did not reveal fistulous communication. CONCLUSION: We suggest that in small and less severe fistulas between the biliary and the bronchial tract, conservative treatment may be used successfully, and invasive treatment methods are not needed in all patients.
Subject(s)
Biliary Fistula/diagnosis , Bronchial Fistula/diagnosis , Cholangiopancreatography, Magnetic Resonance , Aged , Anti-Bacterial Agents/therapeutic use , Biliary Fistula/diagnostic imaging , Biliary Fistula/pathology , Biliary Fistula/therapy , Bronchial Fistula/diagnostic imaging , Bronchial Fistula/pathology , Bronchial Fistula/therapy , Combined Modality Therapy , Female , Fluid Therapy , Humans , Infusions, Intravenous , Predictive Value of Tests , Radiography , Severity of Illness Index , Sodium Chloride/administration & dosage , Treatment OutcomeABSTRACT
INTRODUCTION: The asthma mortality pattern differs among countries. No published evidence is currently available on asthma mortality in a European low-middle-income country in socioeconomic transition. We analyzed the trend of asthma mortality rate in Serbia during the period 1980-2009. MATERIALS AND METHODOLOGY: a descriptive study; source of data: Republic of Serbia Institute of Statistics Death Registry. We analyzed asthma mortality data in the total population, including gender specific analysis, and in the selected ≥ 5-34 year age group. The International Classification of Diseases codes for asthma 493 (1980-1996) and J45 + J46 (1997-2009) were included. Population estimates were based on 1991 and 2002 census data, with extrapolation. RESULTS: The over-all average mortality rate was 7.27 ± 2.14/100,000 inhabitants. The mortality rate peaked in 1981 at 11.3/100,000 but was 4.45/100,000 in the last year of analysis. While both overall mortality rate, as well as gender specific rates, showed clear decreases over the observed 30-year period (average absolute annual decrease of 0.195/100,000 inhabitants, 0.241/100,000 men and 0.149/100,000 women; p < 0.001) with corresponding relative annual decreases of 2.9% for the whole population, 3.0% for men and 2.8% for women, a stable trend of the rate was found in the age group ≥ 5-34 years. Male-to-female ratio was 1.59 ± 0.186, on average and it showed a stable trend over the observed period. CONCLUSION: Although the failure of the health care system during the socioeconomic crisis of the 1990s might have transiently affected asthma mortality rates, the overall mortality rate for the disease shows a favorable decreasing trend.
