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Lee, Kim, Lee, Kim, Yang, Cho, and Kang: A Case of Bronchobiliary Fistula as a Complication of Radiofrequency Ablation
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2012; 72(2): 228-231.

Published online: 29 February 2012

DOI: https://doi.org/10.4046/trd.2012.72.2.228

A Case of Bronchobiliary Fistula as a Complication of Radiofrequency Ablation

Ji Hyun Lee, M.D., Min Su Kim, M.D., Jae Gon Lee, M.D., Dae Sik Kim, M.D., Hae Jin Yang, M.D., Dae Hyeon Cho, M.D., Kyung Woo Kang, M.D.

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.

Address for correspondence: Kyung Woo Kang, M.D. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, 50, Hapseong 2-dong, Masanhoewon-gu, Changwon 630-723, Korea. Phone: 82-55-290-6006, Fax: 82-55-290-6654, kangkw9@naver.com

Received 17 September 2011       Revised 21 September 2011       Accepted 24 October 2011

Copyright © 2012. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

Bronchobiliary fistula (BBF), defined as an abnormal communication between the biliary duct and bronchial trees, is a very rare condition. Bilioptysis is a pathognomonic finding for BBF. We studied a 58-year-old man, who had a BBF complicated by liver biloma that occurred after radiofrequency ablation. The diagnosis was confirmed by the presence of bile-stained sputum and an Endoscopic Retrograde Cholangio-Pancreatography. BBF was treated successfully by endoscopic sphincterotomy and biliary drainage with insertion of a double pig-tail plastic stent into the biloma. We suggest that the optimal choice of treatment modality for BBF depends on the natural course of the underlying disease, and the status of the biliary stricture.

Keywords: Bronchial Fistula, Biliary Fistula, Catheter Ablation

Figures and Tables

Figure 1
Bronchial washing findings. Bile-stained sputum.
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Figure 2
(A) Chest X-ray showing pneumonic infiltration on the right lower lobe. (B) Chest CT showing ground grass opacity and focal consolidation on the right lower lobe. CT: computed tomograrphy.
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Figure 3
(A) Coronal reconstruction of the liver enhanced MRI, showing subcapsular fluid collection communicating with the right bronchial tree. (B) ERCP showing hydatid cyst and a fistulous communication (white arrow) with the right bronchial tree. Bile duct stenosis (black arrow) seen between hydatid cyst and common bile duct. MRI: magnetic resonance imaging; ERCP: endoscopic retrograde cholangio-pancreatography.
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Figure 4
Successful insertion of pig-tail catheter to resolve the bile duct.
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