Learning objectives
To review the most common causes and pathogenesis of acquired bronchobiliary fistula.
To provide an insight on the available diagnostic and therapeutic techniques.
To emphasize the vital role that interventional radiologists have in the diagnosis and treatment of this condition.
Background
Bronchobiliary fistula (BBF) is an uncommon disorder that consists of an abnormal connection between the biliary tract and bronchial tree. Diagnosis and treatment of this condition still remains a challenge, and it is associated with a high rate of morbidity and mortality. Radiologists and especially interventional radiologists play a crucial role in the identification and management of this disease.
Findings and procedure details
ETIOLOGY AND PATHOGENESIS
A review published in 2011 (1) found that the most common cause of acquired BBF are hepatic tumors (primary tumors > metastases) closely followed by bile duct obstruction (due to lithiasis, malignancy, post-operative stricture, etc). They also found that the third most common cause is hepatic hydatidosis, which is still the main etiology in third world countries. Other causes include liver abscess, trauma, iatrogenic fistulas (liver resection, radiofrequency ablation, thoracic drainage, etc.) and chronic pancreatitis (1) (2). Even though it is a...
Conclusion
FBB is a rare and still unknown disorder with high morbi-mortality due to the basal clinical condition of the patients. Radiologists have an important role in the diagnosis of this disease, especially interventional radiology since percutaneous cholangiography provides direct visualization of the fistulous track. Finally, they also have a vital role in the treatment of this disease with percutaneous transhepatic biliary drainage (PTBD) +/- balloon dilatation or stenting, and also with the novel embolization techniques.
Personal information and conflict of interest
A. Antolín Redondo:
Nothing to disclose
M. Perez Lafuente:
Nothing to disclose
C. Gonzalez-Junyent:
Nothing to disclose
I. Diez Miranda:
Nothing to disclose
D. Barnes Navarro:
Nothing to disclose
References
Liao GQ, Wang H, Zhu GY, Zhu KB, Lv FX, Tai S. Management of acquired bronchobiliary fistula: A systematic literature review of 68 cases published in 30 years.World J Gastroenterol. 2011;17(33):3842-3849.
Crnjac A, Pivec V, Ivanecz A. Thoracobiliary fistulas: literature review and a case report of fistula closure with omentum majus.Radiol Oncol. 2013;47(1):77-85.
Xi XJ, Zhang Y, Yin YH, Li H, Ma DD, Qu YQ. Bronchobiliary fistula following radiofrequency ablation for liver metastases from breast cancer: A case report and literature review.Medicine (Baltimore). 2018;97(43):e12760.
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