Detection of a suspected bronchobiliary fistula by hepatobiliary scintigraphy

• Published in: Annals of nuclear medicine Vol. 22; no. 7; pp. 641 - 643
• Main Authors: Annovazzi, Alessio, Viceconte, Giovanni, Romano, Luisa, Sciuto, Rosa, Maini, Carlo L.
• Format: Journal Article
• Language: English
• Published: Japan Springer Japan 01.08.2008; Springer Nature B.V
• Subjects: Aged; Bile - diagnostic imaging; Bile - secretion; Biliary Fistula - diagnostic imaging; Biliary Fistula - etiology; Biliary Fistula - physiopathology; Biliary Fistula - therapy; Bronchial Fistula - diagnostic imaging; Bronchial Fistula - etiology; Bronchial Fistula - physiopathology; Bronchial Fistula - therapy; Case Report; Cautery - adverse effects; Cholangiopancreatography, Endoscopic Retrograde; Cholestasis - diagnostic imaging; Colonic Neoplasms - pathology; Combined Modality Therapy - adverse effects; Drainage; Duodenum - surgery; Escherichia coli Infections - physiopathology; Escherichia coli Infections - therapy; Female; Fever; Hepatectomy - adverse effects; Humans; Imaging; Jaundice, Obstructive - etiology; Jaundice, Obstructive - surgery; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - physiopathology; Liver Neoplasms - secondary; Liver Neoplasms - surgery; Medicine; Medicine & Public Health; Nuclear Medicine; Radiology; Radionuclide Imaging; Stents - adverse effects; Technetium Tc 99m Lidofenin - pharmacokinetics; Tomography, X-Ray Computed; Biliary fistula; Scintigraphy; Tc-HIDA
• ISSN: 0914-7187; 1864-6433
• DOI: 10.1007/s12149-008-0154-z

Bronchobiliary fistula (BBF) represents a rare but severe complication in patients affected by liver metastases. Although a clinical suspicion can arise when specific clinical signs, in particular biliptysis, are present, conventional imaging modalities often fail to confirm the diagnosis. We present a case of a patient affected by colon cancer with liver metastases previously treated with partial right-sided hepatectomy and multiple thermo-ablative treatments combined with chemotherapy, who manifested a septic fever associated with productive cough and biliptysis. Diagnosis of BBF was confirmed only by hepatobiliary scintigraphy with 99m Tc-heptoiminodiacetic acid.