Chronic Cough due to Bronchobiliary Fistula

Abstract

Bronchobiliary fistula is a rare cause of chronic cough. Here we describe a 70-year-old woman complaining of chronic cough and copious dark-yellow watery sputum. The presence of air in the biliary tract in the lower cuts of a computerized tomography scan of the chest and positive bile in the sputum led to the suspicion of bronchobiliary fistula. The diagnosis was confirmed by percutaneous transhepatic cholangiography. Drainage of the intrahepatic biliary tract resulted in complete resolution of her symptoms.

Bronchobiliary fistula: an anesthetic challenge!

“…The majority of cases result from echinococcal and amebic hepatic abscesses. Other causes include biliary tract disease (usually obstructive), thoracoabdominal trauma, tuberculosis, syphilis, Hodgkin's disease, ascariasis, and, rarely, congenital [1][2][3][4].…”

“…Almost all patients with bronchobiliary fistula present with biloptysis, and 50% of these patients present with acute dyspnea and bronchopneumonia. About 75% of patients present with chronic symptoms, productive cough, recurrent pneumonia, and bronchiectasis of the lower lobe [3][4][5].…”

Percutaneous Treatment of a Bronchobiliary Fistula Caused by Cholelithiasis: Case Report

“…This condition may develop after liver surgery, trauma, hydatid disease and choledocholithiasis, or from other causes of a biliary obstruction. The pathogenesis of BBF that s caused by bile duct obstruction probably involves a local inflammatory process (cholangitis) from the high pressure within the bile ducts; this is followed by a liver abscess or biloma development, and there is rupture into the pleural space and lung (3,5). The presence or absence of pleural adhesions could determine if there is the appearance of a bronchobiliary fistula or a pleurobiliary fistula (3,4).…”

Pneumobilia: Benign or life-threatening

“…Symptoms of this condition may be as insidious as a chronic cough (32). Bronchopleurobiliary fistulae have been described after thoracoabdominal trauma, inflammatory lesions of the lower lobe of the lung (i.e.…”