Conservative treatment of bronchobiliary fistula evaluated with magnetic resonance imaging

Tatjana Adžić-Vukičević; Ana Z. Blanka; Aleksandra M. Ilić; Snežana V. Raljević; Ružica M. Maksimović; Srdjan P. Djuranović

doi:10.2298/5655

Tatjana Adžić-Vukičević Clinic for Pulmonology, Clinical Centre of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Ana Z. Blanka Clinic for Pulmonology, Clinical Centre of Serbia, Belgrade, Serbia
Aleksandra M. Ilić Clinic for Pulmonology, Clinical Centre of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Snežana V. Raljević Clinic for Pulmonology, Clinical Centre of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Ružica M. Maksimović Centre for Radiology and Magnetic Resonance Imaging, Clinical Centre of Serbia, Belgrade, Serbia
Srdjan P. Djuranović Clinic for Gastroenterology, Clinical Centre of Serbia, Belgrade, Serbia

DOI: https://doi.org/10.2298/5655

Keywords: bronchial fistula, biliary fistula, diagnosis, magnetic resonance imaging, drug therapy,

Abstract

Introduction. Bronchobiliary fistula (BBF) is a pathological communication between the bronchial system and the biliary tree that presents with bilioptysis. Many conditions can cause its development. There is still no optimal therapy for BBF. Conservative treatment is rarely indicated, as was published before in a few cases. Case report. We presented a 71-year-old Caucasian Serbin woman with BBF secondary to previous laparotomy due to multiple echinococcus liver cysts. The diagnosis was established by the presence of bilirubin and bile acids in sputum and magnetic resonance cholangiopancreatography (MRCP). A repeat MRCP performed after conservative procedure, did not reveal fistulous communication. Conclusion. We suggest that in small and less severe fistulas between the biliary and the bronchial tract, conservative treatment may be used successfully, and invasive treatment methods are not needed in all patients.

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