Bronchobiliary fistula in carcinoma of the hepatic duct bifurcation

• Published in: Deutsche medizinische Wochenschrift Vol. 117; no. 50; p. 1913
• Main Authors: Junga, G, Caduff, B, Christen, B, Kistler, H J
• Format: Journal Article
• Language: German
• Published: Germany 11.12.1992
• Subjects: Adenocarcinoma - complications; Adenocarcinoma - surgery; Aged; Bile Duct Neoplasms - complications; Bile Duct Neoplasms - surgery; Biliary Fistula - diagnosis; Biliary Fistula - diagnostic imaging; Biliary Fistula - etiology; Bronchial Fistula - diagnosis; Bronchial Fistula - diagnostic imaging; Bronchial Fistula - etiology; Cholecystectomy; Cholestasis - etiology; Female; Hepatectomy; Hepatic Duct, Common; Humans; Jejunum - surgery; Tomography, X-Ray Computed
• ISSN: 0012-0472

Carcinoma of the hepatic duct bifurcation was diagnosed in a 67-year-old women with obstructive jaundice. As metastatic spread could not be demonstrated the carcinoma was removed with a view of achieving a cure (hemihepatectomy, resection of the hepatic duct and the bifurcation, cholecystectomy and hepatojejunostomy). Histological examination indicated adenocarcinoma of the biliary tract. Seven months postoperatively the patient was found to be cachectic and cough up greenish liquid sputum. Bilirubin concentration in sputum was 500 mumol/l. There was no jaundice and total bilirubin concentration was 33 mumol/l. Alkaline phosphatase was 508 U/l, but GOT and GPT were normal (23 U/l and 21 U/l). Computed tomography confirmed the clinical diagnosis of a biliobronchial fistula. The patient died 9 days after renewed hospitalization of tumour cachexia. The biliobronchial fistula was found at necropsy.