RESUMO
Broncho-biliary fistula (BBF) is a rare but severe disorder defined as abnormal communication between the biliary system and bronchial tree. Cases of BBF have occasionally been reported, but no standard treatment has been established. We report two cases of BBF that developed after the treatment of hepatocellular carcinoma (HCC) and reviewed the relevant literature. Case 1, a man in his early eighties was diagnosed with BBF 4 months after undergoing surgical resection for HCC (diameter, 7 cm; location, segments 4 and 5). Percutaneous drainage and endoscopic nasobiliary drainage (ENBD) improved BBF without recurrence for more than a year. Case 2, a woman in her late sixties was diagnosed with BBF after percutaneous radiofrequency ablation for HCC. Although the BBF was treated with ENBD, bronchial occlusion, and percutaneous transhepatic portal vein embolization, these treatments were unsuccessful and the patient died. Although non-invasive treatments have been developed, refractory BBF still exists. The prediction of BBF and the development of more effective treatments are necessary to improve outcomes.
Assuntos
Fístula Biliar , Carcinoma Hepatocelular , Neoplasias Hepáticas , Idoso , Idoso de 80 Anos ou mais , Fístula Biliar/diagnóstico por imagem , Fístula Biliar/etiologia , Fístula Biliar/cirurgia , Carcinoma Hepatocelular/cirurgia , Drenagem , Feminino , Humanos , Neoplasias Hepáticas/cirurgia , Masculino , Recidiva Local de NeoplasiaRESUMO
BACKGROUND: The biliary bronchial fistula is rare and difficult to treat. Here we report a 49-year-old woman diagnosed with biliary bronchial fistula due to cough with yellow-green sputum. CASE PRESENTATION: this is a typical case of the biliary bronchial fistula with typical symptoms. The position of the abscess cavity below the diaphragm could not be catheter drainage. After anti-infection treatment, yellow-green sputum was reduced. Follow-up showed a good prognosis. CONCLUSION: biliary bronchial fistula is rare in the clinic, combined with chest and abdomen infection.
RESUMO
We present a case report of broncho-biliary fistula that developed due to the blockage of biliary stent placed during the management of pancreatic neuroendocrine tumor (pNET); diagnosed on high clinical suspicion, percutaneous cholangiogram and contrast enhanced computed tomography (CECT); and successfully treated with percutaneous transhepatic biliary drainage (PTBD).
Assuntos
Fístula Biliar/etiologia , Neoplasias Ósseas/secundário , Fístula Brônquica/etiologia , Colestase/complicações , Abscesso Pulmonar/complicações , Tumores Neuroendócrinos/complicações , Neoplasias Pancreáticas/complicações , Adulto , Ductos Biliares Intra-Hepáticos/diagnóstico por imagem , Ductos Biliares Intra-Hepáticos/cirurgia , Fístula Biliar/diagnóstico por imagem , Biópsia por Agulha Fina , Neoplasias Ósseas/terapia , Fístula Brônquica/diagnóstico por imagem , Colangiopancreatografia Retrógrada Endoscópica , Colestase/etiologia , Colestase/cirurgia , Empiema Pleural/diagnóstico por imagem , Empiema Pleural/cirurgia , Feminino , Humanos , Icterícia Obstrutiva/cirurgia , Abscesso Pulmonar/diagnóstico por imagem , Abscesso Pulmonar/etiologia , Tumores Neuroendócrinos/diagnóstico por imagem , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/patologia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , StentsRESUMO
A fístula bíleo-brônquica é uma condição rara que pode ocorrer em decorrência de cistos hidáticos, intervenções cirúrgicas extensas e procedimentos invasivos para doença hepáticas. O objetivo deste trabalho é relatar o caso de um paciente com diagnóstico de fístula bíleo-brônquica após ferimento por arma de fogo que transfixou o tórax. Ressalta-se a importância de novos relatos a fim de dinamizar o diagnóstico e tratamento desses pacientes e assim diminuírem as morbidades relacionadas.
Broncho-biliary fistula is a rare condition that can occur due to hydatid cysts, extensive surgical interventions, and invasive procedures for liver disease. The aim of this study is to report the case of a patient with a diagnosis of broncho-biliary fistula after a gunshot wound that transfixed the chest. We stress the importance of new reports to streamline the diagnosis and treatment of these patients and thus decrease related morbidities.