Year 2017 / Volume 109 / Number 4
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A bronchobiliary fistula treated with cyanoacrylate glue in a patient with liver cirrhosis

288

Raúl Honrubia López, Ana Barbado Cano, Gloria Ruiz Fernández, Katherine Yelenia Bustamante Robles,

Abstract
A 60-year-old male was operated upon in 2002 for liver hydatidosis, which included partial right hepatectomy with cholecystectomy and bilioduodenal anastomosis. He then developed liver cirrhosis secondary to left hepatic duct stricture. He presents at the emergency room with dry cough, which he had for a month and then became associated with yellowish, bitter-tasting "fluid" expectoration. A chest-abdominal CT scan revealed a 6 x 5-cm collection roughly located somewhere between the middle pulmonary lobe and subphrenic area . A fistula was suspected, which prompted a sputum biochemistry test that was positive for bilirubin. Given the patient's impaired liver function because of his liver disease conservative treatment was initiated with an inner-outer drain under transparietal hepatic cholangiography (TPHC) to promote bile outflow via the duodenum. Subsequently, TPHC was used to locate the point where contrast leaked from the biliary tree into a pleural cavity, and the fistula was sealed using cyanoacrylate glue, which resulted in improved symptomatology.
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References
1. Altorio RA, McAllister JD, Sestric GB, et al. Hepatopulmonary fistula: treatment with biliary metallic endoprosthesis. Am J Gastroenterol 1992 Jun 87 (6):784-786.
2 .Rose DM, Rose AT, Chapman WC, et al. Management of bronchobiliary fistula as a late complication of hepatic resection. Am Surg 1998 Sep 64(9):873-876.
3. Watkins L, Laufer I, Evans G, et al. Biliary-bronchial fistula demonstrated by endoscopic retrograde cholnagiography. Can Med Assoc J 1975 Nov 8; 113(9):868-874.
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Honrubia López R, Barbado Cano A, Ruiz Fernández G, Bustamante Robles K. A bronchobiliary fistula treated with cyanoacrylate glue in a patient with liver cirrhosis . 4541/2016


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Publication history

Received: 14/07/2016

Accepted: 20/07/2016

Published: 31/03/2017

Article editing time: 260 days


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