Bronchobiliary Fistula After Liver Transplantation

Yeatman, C. Fitzhugh; Fisher, Robert A.; Carucci, Laura R.; Halvorsen, Robert A.

doi:10.1097/01.rct.0000131583.52386.cf

Cited by 12 publications

(4 citation statements)

References 7 publications

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“…She developed biliary stricture and right subphrenic bile collection leading to BBF, for which she underwent percutaneous transhepatic biliary drainage (PTBD) [ 4 ]. A similar case was reported by Yeatman et al [ 5 ]. The likely mechanism of the development of BBF in a post-LT setting is hypothesized to be because of the biliary stricture and bile leak in the subphrenic space, where bile acts as a tissue-corrosive agent, leading to the erosion of the diaphragm and subsequent communication with the right-hand bronchial tract.…”

Section: Discussionsupporting

confidence: 86%

“…In 1850 Peacock et al [ 1 ] reported the first BBF case in a young woman with a ruptured hydatid cyst. Both the acquired and the congenital varieties of BBF are very rare complications in children [ 2 - 5 ]. Acquired BBF usually occurs as a complication of a rupture of a hydatid cyst or subphrenic abscess.…”

Section: Introductionmentioning

confidence: 99%

“…A high index of suspicion and early diagnosis are crucial to prevent progressive corrosion of pulmonary and bronchial tissues. In the context of liver transplantation (LT), only a few cases have been reported in adults [ 4 , 5 ]. However, no such data exist in the pediatric LT setting to the best of our knowledge.…”

Section: Introductionmentioning

confidence: 99%

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Delayed diagnosis of bronchobiliary fistula complicating a pediatric living donor liver transplantation: a case report

Gautam,

Kumar,

Agarwal

et al. 2023

Korean J Transplant

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Bronchobiliary fistula (BBF) is a very rare condition in children. Only a few pediatric BBF cases have been reported, in the context of a ruptured hydatid cyst or liver abscess. BBF after living donor liver transplantation (LDLT) has not been reported in the pediatric literature. We report a 7-year-old female child with Wilson disease, who developed BBF post-LDLT. She had a clinically uneventful course in the immediate post-transplant period. She was readmitted on postoperative day (POD) 75 with a productive cough and respiratory difficulty, which was diagnosed as bilioptysis secondary to BBF. Endoscopic retrograde cholangiopancreaticography was attempted but failed. Exploratory laparotomy showed a fistula from the strictured biliary anastomotic site to the right thoracic cavity; it was excised, and a Roux-en-Y hepaticojejunostomy was performed. She tolerated the procedure well and remained clinically well on follow-up through POD 185. BBF is extremely rare in children. This is the first case report of BBF in a child following LDLT. BBF requires a high index of suspicion for a timely intervention to prevent subsequent complications.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

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Delayed diagnosis of bronchobiliary fistula complicating a pediatric living donor liver transplantation: a case report

Gautam,

Kumar,

Agarwal

et al. 2023

Korean J Transplant

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“…It is a rare complication that may appear in the natural history of liver hydatid disease or after its surgical treatment [1, 2], trauma [3], congenital malformation [4–6], tumor [7], surgery [8–10], biliary lithiasis [11], hepatic abscess [12], liver transplantation [13], or even radiofrequency treatment [14, 15]. …”

Section: Introductionmentioning

confidence: 99%

Biliobronchial Fistula after Liver Surgery for Giant Hydatid Cyst

et al. 2011

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Background. Biliobronchial fistula (BBF) is a rare complication in the natural history of liver hydatid disease by Echinococcus granulosus. We present a case of BBF after resection of a giant liver hydatid cyst in a 72-year-old woman. Case Report. A total cystpericystectomy was done, leaving the left lateral section of the liver that was fixed to the diaphragm. Postoperatively, the patient developed obstructive jaundice. An ERCP showed an obstruction at the junction of the left biliary duct and the main biliary duct and contrast leak. At reoperation, the main duct was ischemic, likely due to torsion along its longitudinal axis. A hepatotomy was done at the hilar plate, and the biliary duct was dissected and anastomosed to a Roux-en-Y jejunal loop. She was discharged without complications. Five months later, the patient developed cholangitis and was successfully treated with antibiotics. However, she suffered repeated respiratory infections, and four months later she was admitted to the hospital with fever, cough, bilioptysis, and right lower lobe pneumonia. The diagnosis of BBF was confirmed with 99mTc Mebrofenin scintigraphy. At transhepatic cholangiography, bile duct dilation was seen, with a biliothoracic leak. She underwent dilatation of cholangiojejunostomy stricture with placement of an external-internal catheter. The catheter was removed 3.5 months later, and two years later the patient remains in very good condition. Conclusion. An indirect treatment of the BBF by percutaneous transhepatic dilation of the biliary stenosis avoided a more invasive treatment, with satisfactory outcome.

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Congenital and Developmental Diseases

Stocker

2008

Dail and Hammar’s Pulmonary Pathology

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Bronchobiliary Fistula After Liver Transplantation

Abstract: This report describes the imaging findings of the first reported case of a bronchobiliary fistula that developed as a complication of liver transplantation. The diagnosis was confirmed by the aspiration of bile from the bronchus.

Cited by 12 publications

References 7 publications

Delayed diagnosis of bronchobiliary fistula complicating a pediatric living donor liver transplantation: a case report

Delayed diagnosis of bronchobiliary fistula complicating a pediatric living donor liver transplantation: a case report

Biliobronchial Fistula after Liver Surgery for Giant Hydatid Cyst

Congenital and Developmental Diseases

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