ABSTRACT
A hepatobronchial fistula is an anatomic communication between the liver parenchyma and the bronchial tree. Major causes of such fistulae include inflammatory conditions resulting from obstruction of the biliary tract and infectious processes, such as pyogenic liver abscesses, amoebiasis, and hydatid cysts. We report a rare case of a patient (with a chronic, recurrent hepatic abscess) who suffered a persistent, productive cough resulting from a hepatobronchial fistula.
Subject(s)
Bronchial Fistula/etiology , Cough/etiology , Liver Abscess, Pyogenic/complications , Anti-Bacterial Agents/therapeutic use , Bronchial Fistula/diagnosis , Bronchial Fistula/metabolism , Chronic Disease , Clostridium Infections/complications , Clostridium Infections/drug therapy , Clostridium Infections/microbiology , Clostridium perfringens/isolation & purification , Enterococcus faecalis/isolation & purification , Gram-Positive Bacterial Infections/complications , Gram-Positive Bacterial Infections/drug therapy , Gram-Positive Bacterial Infections/microbiology , Humans , Klebsiella Infections/complications , Klebsiella Infections/drug therapy , Klebsiella Infections/microbiology , Klebsiella pneumoniae/isolation & purification , Liver Abscess, Pyogenic/drug therapy , Liver Abscess, Pyogenic/microbiology , Male , Middle Aged , Recurrence , Sputum/metabolism , Treatment OutcomeABSTRACT
The article discusses the results of treatment of 84 patients with postresection tuberculous pyothorax and bronchial fistulas with hyperbaric oxygenation session (HBO) included in the complex of therapeutic measures. As a result, the bronchial fistulas closed in 30 (35.7%) patients, the diameter of the fistulas reduced markedly in 20 (24.3%) patients, the bronchial fistulas failed to close in 40% of cases. As the result of HBO therapy the count of red cells and lymphocytes increased, leukocytosis and eosinophilia reduced, the ESR diminished. The content of ALT transaminase, sugar, total protein and bilirubin decreased. The migration index for all immune antigens in the reaction of leukocyte migration inhibition and in the nitro blue tetrazolium test increased. HBO promoted the efficacy of radical operations by 29.4% as compared to that in the control group of the similar patients.
