Introduction. Biliobronchial fistula is rare. Very rarely it may be
congenital, more frequently it is acquired as a complication of the hydatide
cyst of the liver, pyogenic abscess, serious trauma and resection of the
liver as well as recurrent cholangitis due to benign bile duct stricture or
cholangiolithiasis. The main causes of the biliobronchial fistula are
billiary obstruction and infectious lesion (abscess) in the liver. Case
Outline. We present a 56-year-old man with benign stricture of the
hepaticojejunostomy performed after operative common bile duct injury, who
developed biliobronchial fistula following repeated percutaneous drainage of
the liver abscess and percutaneous dilatation of the strictured anastomosis.
Over the years the patient developed atrophy/hypertrophy complex, portal
hypertension, grade II esophageal varicosities, ascites and splenomegaly.
Although biliobronchial fistula was solved by a successful surgical
reconstruction (new wide hepaticojejunostomy), the operation had a limited
value as it was performed late after permanent lesions of the liver and
intrahepatic bile ducts had already developed. Conclusion. Surgical
reconstruction of strictured biliodigestive anastomosis should be considered
on time as a possibly better solution than percutaneous dilatation. According
to the authors? knowledge, a similar case of biliobronchial fistula as a
complication of percutaneous dilatation of the benign biliary stricture has
not been reported before in the literature.
What Is the Cause of This Biliary Stricture?
