Late onset of biliobronchial fistula — a serious complication of hemihepatectomy for atrophic liver with hepatolithiasis: a case report and review of the literature
Abstract Background Acquired bronchobiliary fistula (BBF) is a rare but life-threatening complication that can occur as a result of oncological processes, inflammatory reactions, parasite infections, thoracoabdominal trauma, or invasive procedures associated with iatrogenic injury. However, the pote...
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| Language: | English |
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BMC
2024-12-01
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| Series: | Journal of Cardiothoracic Surgery |
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| Online Access: | https://doi.org/10.1186/s13019-024-03176-x |
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| author | Chen-Ze Yan Zhong Jia Ya-Feng Wan He-Shan Zhou |
| author_facet | Chen-Ze Yan Zhong Jia Ya-Feng Wan He-Shan Zhou |
| author_sort | Chen-Ze Yan |
| collection | DOAJ |
| description | Abstract Background Acquired bronchobiliary fistula (BBF) is a rare but life-threatening complication that can occur as a result of oncological processes, inflammatory reactions, parasite infections, thoracoabdominal trauma, or invasive procedures associated with iatrogenic injury. However, the potential etiology of BBF caused by instrumental issues when using ultrasonic scalpels resulting in diathermy burn and its post-burn effects has never been reported. Case presentation Herein, we present a case of a 65-year-old woman who developed BBF one month after hepatectomy and presented with refractory irritating cough accompanied by yellow bitter sputum. The diagnosis was confirmed through detection of bile components in the sputum, fiberoptic bronchoscopy examination, and endoscopic retrograde cholangio-pancreatography (ERCP). Unfortunately, both endobronchial blocker and endoscopic nasobiliary drainage (ENBD) failed to address the condition until surgical removal of the involved subdiaphragmatic fistula followed by pedicled greater omentum tamping were performed. After closure of the fistula during a 5-month follow-up period, she did not experience any further episodes of biloptysis. Conclusions For diathermy burn associated BBF, non-surgical management proves difficult due to inadequate or ineffective biliary drainage, so that early surgical intervention should be considered as an effective approach. Moreover, the adhesion between the atrophied liver and the diaphragm may pose a significant risk factor for diathermy burn, necessitating heightened vigilance. |
| format | Article |
| id | doaj-art-eb405526badb4051b9fbc3a1d68bdaf3 |
| institution | Kabale University |
| issn | 1749-8090 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj-art-eb405526badb4051b9fbc3a1d68bdaf32024-12-22T12:47:01ZengBMCJournal of Cardiothoracic Surgery1749-80902024-12-011911510.1186/s13019-024-03176-xLate onset of biliobronchial fistula — a serious complication of hemihepatectomy for atrophic liver with hepatolithiasis: a case report and review of the literatureChen-Ze Yan0Zhong Jia1Ya-Feng Wan2He-Shan Zhou3The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou First People’s HospitalDepartment of Hepatobiliary Surgery, Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake UniversityDepartment of Hepatobiliary Surgery, Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake UniversityDepartment of Radiology, Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake UniversityAbstract Background Acquired bronchobiliary fistula (BBF) is a rare but life-threatening complication that can occur as a result of oncological processes, inflammatory reactions, parasite infections, thoracoabdominal trauma, or invasive procedures associated with iatrogenic injury. However, the potential etiology of BBF caused by instrumental issues when using ultrasonic scalpels resulting in diathermy burn and its post-burn effects has never been reported. Case presentation Herein, we present a case of a 65-year-old woman who developed BBF one month after hepatectomy and presented with refractory irritating cough accompanied by yellow bitter sputum. The diagnosis was confirmed through detection of bile components in the sputum, fiberoptic bronchoscopy examination, and endoscopic retrograde cholangio-pancreatography (ERCP). Unfortunately, both endobronchial blocker and endoscopic nasobiliary drainage (ENBD) failed to address the condition until surgical removal of the involved subdiaphragmatic fistula followed by pedicled greater omentum tamping were performed. After closure of the fistula during a 5-month follow-up period, she did not experience any further episodes of biloptysis. Conclusions For diathermy burn associated BBF, non-surgical management proves difficult due to inadequate or ineffective biliary drainage, so that early surgical intervention should be considered as an effective approach. Moreover, the adhesion between the atrophied liver and the diaphragm may pose a significant risk factor for diathermy burn, necessitating heightened vigilance.https://doi.org/10.1186/s13019-024-03176-xBronchobiliary FistulaIatrogenic InjuryDiathermy BurnSurgical intervention |
| spellingShingle | Chen-Ze Yan Zhong Jia Ya-Feng Wan He-Shan Zhou Late onset of biliobronchial fistula — a serious complication of hemihepatectomy for atrophic liver with hepatolithiasis: a case report and review of the literature Journal of Cardiothoracic Surgery Bronchobiliary Fistula Iatrogenic Injury Diathermy Burn Surgical intervention |
| title | Late onset of biliobronchial fistula — a serious complication of hemihepatectomy for atrophic liver with hepatolithiasis: a case report and review of the literature |
| title_full | Late onset of biliobronchial fistula — a serious complication of hemihepatectomy for atrophic liver with hepatolithiasis: a case report and review of the literature |
| title_fullStr | Late onset of biliobronchial fistula — a serious complication of hemihepatectomy for atrophic liver with hepatolithiasis: a case report and review of the literature |
| title_full_unstemmed | Late onset of biliobronchial fistula — a serious complication of hemihepatectomy for atrophic liver with hepatolithiasis: a case report and review of the literature |
| title_short | Late onset of biliobronchial fistula — a serious complication of hemihepatectomy for atrophic liver with hepatolithiasis: a case report and review of the literature |
| title_sort | late onset of biliobronchial fistula a serious complication of hemihepatectomy for atrophic liver with hepatolithiasis a case report and review of the literature |
| topic | Bronchobiliary Fistula Iatrogenic Injury Diathermy Burn Surgical intervention |
| url | https://doi.org/10.1186/s13019-024-03176-x |
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