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Lee, Lee, Kim, Lee, Jung, Park, Jung, Son, Yoon, Kang, Park, Kim, Chang, Kim, and Moon: Bilioptysis Caused by Bronchobiliary Fistula Secondary to Sclerosing Therapy of Liver Cyst
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2010; 69(2): 119-123.

Published online: 31 August 2010

DOI: https://doi.org/10.4046/trd.2010.69.2.119

Bilioptysis Caused by Bronchobiliary Fistula Secondary to Sclerosing Therapy of Liver Cyst

Sang Hoon Lee, M.D.1, Kyung Jong Lee, M.D.1, Song Yee Kim, M.D.1, Sang Kook Lee, M.D.1, Kyu Sik Jung, M.D.1, Byung Hoon Park, M.D.1, Ji Ye Jung, M.D.1, Ji Young Son, M.D.1, Yoe Wun Yoon, M.D.1, Young Ae Kang, M.D.1, 2, Moo Suk Park, M.D.1, 2, Young Sam Kim, M.D.1, 2, Joon Chang, M.D.1, 2, Se Kyu Kim, M.D.1, 2, Jin Wook Moon, M.D.1, 2

1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

2The Institute of Chest Diseases, Yonsei University College of Medicine, Seoul, Korea.

Address for correspondence: Jin Wook Moon, M.D. Department of Internal Medicine, Yonsei University College of Medicine, 250, Seongsan-no, Sudaemoon-gu, Seoul 120-752, Korea. Phone: 82-2-2228-1996, Fax: 82-2-393-6884, jwmoon@yuhs.ac

Received 10 March 2010       Accepted 27 April 2010

Copyright © 2010. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

Bronchobiliary fistula is a rare disorder consisting of an abnormal communication between the bronchial tree and the biliary duct. In Western countries, trauma, postoperative biliary stenosis, and biliary lithiasis are the predominant causative factors of bronchobiliary fistula. Bilioptysis (bile stained sputum) is a pathognomic finding for bronchobiliary fistula. To date, there are just a few reported cases of bronchobiliary fistula after sclerosis of a liver cyst. We describe the case of a 74-year-old woman who developed bronchobiliary fistula after sclerosing therapy of a liver cyst. The diagnosis was confirmed by the presence of bilioptysis and the chest and dynamic liver CT findings. The patient was successfully treated with antibiotics and percutaneous transhepatic catheter drainage.

Keywords: Cyst, Hepatic, Bronchobiliary fistula, Bilioptysis, Sclerosing injections

Figures and Tables

Figure 1
This picture shows bile-stained sputum.
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Figure 2
The chest X-ray shows consolidation on the right lower lung field.
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Figure 3
The initial chest CT reveals secondary abscess of lung due to liver cyst infection and diaphragm rupture.
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Figure 4
(A, B) The liver CT shows extrahepatic biloma and abscess formation with pleural fistula (arrow).
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Figure 5
The follow-up chest CT reveals an improvement of the previous lung abscess and extrahepatic biloma.
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