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Lee, Song, Jeong, and Kim: Hepatobronchial Fistula and Lung Abscess after Transarterial Chemoembolization
Case Report

The Korean Journal of Gastroenterology 2017; 69(5): 316-320.

Published online: 25 May 2017

DOI: https://doi.org/10.4166/kjg.2017.69.5.316

Hepatobronchial Fistula and Lung Abscess after Transarterial Chemoembolization

Kwanjoo Lee, Jeong Eun Song, Hyang Sook Jeong1, Do Young Kim

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

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

Correspondence to: Do Young Kim, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. Tel: +82-2-2228-1992, Fax: +82-2-393-6884, dyk1025@yuhs.ac

Received 14 February 2017       Revised 15 April 2017       Accepted 15 April 2017

Copyright © 2017. Korean Society of Gastroenterology

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Transarterial chemoembolization (TACE) is a common treatment modality to locally manage hepatocellular carcinoma. Liver abscess and bile duct injury are common complications of TACE. However, hepatobronchial fistula is a rare complication. Herein, we report a case of lung abscess due to hepatobronchial fistula after TACE. A 67-year-old man, who had underwent TACE 6 months ago, presented cough and bile-colored sputum. He was diagnosed with lung abscess and hepatobronchial fistula. We performed endoscopic retrograde cholangiopancreatography; however, there was no improvement in his symptoms. Thereafter, partial hepatectomy and repair of fistula were successively conducted.

Keywords: Chemoembolization, therapeutic, Bronchial fistula, Carcinoma, hepatocellular, Lung abscess

Figures and Tables

Fig. 1

Contrast-enhanced chest computed tomography at admission day. Hepatic abscess and lung abscess are shown in this image. The arrow indicates fistula between lung abscess and liver abscess.

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Fig. 2

Cholangiography via hepatic abscess drainage catheter. The arrow indicates contrast dye leakage from hepatic abscess to bronchus.

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Fig. 3

Endoscopic retrograde cholangiopancreatography (ERCP) image. Endoscopic retrograde bile drainage was inserted via ERCP to treat hepatobronchial fistula by decompressing biliary pressure.

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Fig. 4

Microscopic findings of the resected specimen (H&E, ×200). Postoperative pathology shows acute inflammation (neutrophil dominant) and necrosis.

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Fig. 5

Microscopic findings of the resected specimen (H&E, ×200). Postoperative pathology shows acute inflammation (neutrophil dominant) and some viable cancer cells (arrows).

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Fig. 6

Liver-pelvic contrast dynamic computed tomography after repair operation. The arrow indicates repaired fistula at the diaphragm.

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Notes

Financial support None.

Conflict of interest None.

References

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