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Background: Hepatobronchial fistula is infrequent and secondary to pyogenic abscess caused by Streptococcus intermedius. This agent causes infections such as hepatic abscesses, endocarditis, bacteremia, and others. The treatment includes drainage, antibiotic management, and surgical intervention in some cases. Case Presentation: We describe a case of a 50-year-old male with a pyogenic liver abscess complicated by hepatobronchial fistula, admitted to the Internal Medicine Department with fever, long-lasting chills, and weight loss. The diagnostic approach revealed a pyogenic abscess secondary to S. intermedius. After percutaneous drainage, the patient presented purulent expectoration. A cavitogram revealed a hepatobronchial fistula. Treatment with antibiotics and closure of the defect was satisfactory. Conclusion: This is a case of a hepatic abscess due to S. intermedius complicated with hepatobronchial fistula, a rare clinical entity; the opportune hybrid approach (surgical plus interventional and radiological) reduces the risk of a major thoracoabdominal operation, which influenced the good prognosis of our patient.

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Objective: The aim of this study is to demonstrate an original technique in which a stable construct is made by fibular and calcaneal bone tunnels producing a figure of 8 with a Polyester implant as revision for failed primary ligament reconstruction. Methods: This is a retrospective study of 19 patients with persistent lateral ankle instability diagnosis after a primary ligament repair treated between 2011 and 2019. The surgical technique is described in detail in which stabilization of the lateral ankle is performed. 11 men and 8 women with a mean age of 30.94 years (15-53). Follow up was 29.05 months (6-109). Pre and postoperative AOFAS ankle score were used as well as an AVS and a satisfaction questionnaire. Results: There was a significant improvement in AOFAS score, 76.31 to 91.47 (<0.001). All the patients except one, stated to have a stable ankle and be Very satisfied (16) or satisfied (2) with the procedure. No infection was presented in any patient. Conclusion: This technique is a reliable alternative in patients in which primary ankle ligaments have failed and no autograft or allograft are wanted to be used. Level of Evidence V; Therapeutic Study; Expert Opinion.