Congenital Direct Communication Between Biliary System and Respiratory Tract

Video-assisted Thoracoscopic Resection of a Congenital Tracheobiliary Fistula in a Neonate: Technical Report and Review of the Literature

“…The embryologic origin of these fistulae is not well-understood, however, histologic evaluation of resected specimens yields the hypothesis that fistulae may develop by fusion of an anomalous bronchial bud with an aberrant bile duct 15. Other reports have described a pattern of bronchial histopathologic features in the proximal segment of the resected fistula tract transitioning to tissue with GI and biliary characteristics in the distal portion,4,20 findings consistent with the histopathology in our case. An alternate theory proposes that fistulae may develop secondary to duplication of the upper GI tract, as evidenced by several reports which found esophageal and/or gastric mucosa in the mid-portion of the fistula 40…”

“…Along with concern for tracheoesophageal fistula, the differential for findings such as these is broad and should include gastroesophageal reflux, GI obstruction, and aspiration pneumonia. 4,9 Delay in diagnosis and treatment can lead to life-threatening complications including respiratory failure secondary to biliary pneumonitis or pneumonia. The use of extracorporeal membrane oxygenation and death because of sepsis has been reported.…”

“…Patients usually present within the first weeks of life with characteristic respiratory symptoms including cough, progressive respiratory distress associated with x-ray findings consistent with aspiration pneumonia and bilious sputum/emesis in the context of reassuring abdominal examination and imaging. Along with concern for tracheoesophageal fistula, the differential for findings such as these is broad and should include gastroesophageal reflux, GI obstruction, and aspiration pneumonia 4,9. Delay in diagnosis and treatment can lead to life-threatening complications including respiratory failure secondary to biliary pneumonitis or pneumonia.…”

Video-assisted Thoracoscopic Resection of a Congenital Tracheobiliary Fistula in a Neonate: Technical Report and Review of the Literature

“…The embryologic origin of these fistulae is not well-understood, however, histologic evaluation of resected specimens yields the hypothesis that fistulae may develop by fusion of an anomalous bronchial bud with an aberrant bile duct 15. Other reports have described a pattern of bronchial histopathologic features in the proximal segment of the resected fistula tract transitioning to tissue with GI and biliary characteristics in the distal portion,4,20 findings consistent with the histopathology in our case. An alternate theory proposes that fistulae may develop secondary to duplication of the upper GI tract, as evidenced by several reports which found esophageal and/or gastric mucosa in the mid-portion of the fistula 40…”

“…Along with concern for tracheoesophageal fistula, the differential for findings such as these is broad and should include gastroesophageal reflux, GI obstruction, and aspiration pneumonia. 4,9 Delay in diagnosis and treatment can lead to life-threatening complications including respiratory failure secondary to biliary pneumonitis or pneumonia. The use of extracorporeal membrane oxygenation and death because of sepsis has been reported.…”

“…Patients usually present within the first weeks of life with characteristic respiratory symptoms including cough, progressive respiratory distress associated with x-ray findings consistent with aspiration pneumonia and bilious sputum/emesis in the context of reassuring abdominal examination and imaging. Along with concern for tracheoesophageal fistula, the differential for findings such as these is broad and should include gastroesophageal reflux, GI obstruction, and aspiration pneumonia 4,9. Delay in diagnosis and treatment can lead to life-threatening complications including respiratory failure secondary to biliary pneumonitis or pneumonia.…”

Congenital bronchobiliary fistula: A case report and review of the literature

“…The first findings on CBBF were reported in 1952 by Neuhauser et al[6]. Altogether, there were 43 additional cases reported in English and 1 in Chinese thereafter (Table 1), and CBBF was more common in women than in men.…”

Diagnosis of congenital bronchobiliary fistula in children by bilirubin crystallization in the bronchoalveolar lavage fluid: A case report and literature review

“…One case with no surgery. CBBF patients with delayed or no operation, severe biliary malformation, or severe postoperative complications have poor prognosis [17,23,24,28].…”

Video-assisted Thoracoscopic Resection of a Congenital Tracheobiliary Fistula in a Neonate: Technical Report and Review of the Literature

“…The embryologic origin of these fistulae is not well-understood, however, histologic evaluation of resected specimens yields the hypothesis that fistulae may develop by fusion of an anomalous bronchial bud with an aberrant bile duct 15. Other reports have described a pattern of bronchial histopathologic features in the proximal segment of the resected fistula tract transitioning to tissue with GI and biliary characteristics in the distal portion,4,20 findings consistent with the histopathology in our case. An alternate theory proposes that fistulae may develop secondary to duplication of the upper GI tract, as evidenced by several reports which found esophageal and/or gastric mucosa in the mid-portion of the fistula 40…”

“…Along with concern for tracheoesophageal fistula, the differential for findings such as these is broad and should include gastroesophageal reflux, GI obstruction, and aspiration pneumonia. 4,9 Delay in diagnosis and treatment can lead to life-threatening complications including respiratory failure secondary to biliary pneumonitis or pneumonia. The use of extracorporeal membrane oxygenation and death because of sepsis has been reported.…”

“…Patients usually present within the first weeks of life with characteristic respiratory symptoms including cough, progressive respiratory distress associated with x-ray findings consistent with aspiration pneumonia and bilious sputum/emesis in the context of reassuring abdominal examination and imaging. Along with concern for tracheoesophageal fistula, the differential for findings such as these is broad and should include gastroesophageal reflux, GI obstruction, and aspiration pneumonia 4,9. Delay in diagnosis and treatment can lead to life-threatening complications including respiratory failure secondary to biliary pneumonitis or pneumonia.…”

Congenital bronchobiliary fistula: A case report and review of the literature

“…The first findings on CBBF were reported in 1952 by Neuhauser et al[6]. Altogether, there were 43 additional cases reported in English and 1 in Chinese thereafter (Table 1), and CBBF was more common in women than in men.…”

Diagnosis of congenital bronchobiliary fistula in children by bilirubin crystallization in the bronchoalveolar lavage fluid: A case report and literature review

“…One case with no surgery. CBBF patients with delayed or no operation, severe biliary malformation, or severe postoperative complications have poor prognosis [17,23,24,28].…”

Video-assisted Thoracoscopic Resection of a Congenital Tracheobiliary Fistula in a Neonate: Technical Report and Review of the Literature

“…The embryologic origin of these fistulae is not well-understood, however, histologic evaluation of resected specimens yields the hypothesis that fistulae may develop by fusion of an anomalous bronchial bud with an aberrant bile duct 15. Other reports have described a pattern of bronchial histopathologic features in the proximal segment of the resected fistula tract transitioning to tissue with GI and biliary characteristics in the distal portion,4,20 findings consistent with the histopathology in our case. An alternate theory proposes that fistulae may develop secondary to duplication of the upper GI tract, as evidenced by several reports which found esophageal and/or gastric mucosa in the mid-portion of the fistula 40…”

“…Along with concern for tracheoesophageal fistula, the differential for findings such as these is broad and should include gastroesophageal reflux, GI obstruction, and aspiration pneumonia. 4,9 Delay in diagnosis and treatment can lead to life-threatening complications including respiratory failure secondary to biliary pneumonitis or pneumonia. The use of extracorporeal membrane oxygenation and death because of sepsis has been reported.…”

“…Patients usually present within the first weeks of life with characteristic respiratory symptoms including cough, progressive respiratory distress associated with x-ray findings consistent with aspiration pneumonia and bilious sputum/emesis in the context of reassuring abdominal examination and imaging. Along with concern for tracheoesophageal fistula, the differential for findings such as these is broad and should include gastroesophageal reflux, GI obstruction, and aspiration pneumonia 4,9. Delay in diagnosis and treatment can lead to life-threatening complications including respiratory failure secondary to biliary pneumonitis or pneumonia.…”

Congenital bronchobiliary fistula: A case report and review of the literature

“…The first findings on CBBF were reported in 1952 by Neuhauser et al[6]. Altogether, there were 43 additional cases reported in English and 1 in Chinese thereafter (Table 1), and CBBF was more common in women than in men.…”

Diagnosis of congenital bronchobiliary fistula in children by bilirubin crystallization in the bronchoalveolar lavage fluid: A case report and literature review

“…One case with no surgery. CBBF patients with delayed or no operation, severe biliary malformation, or severe postoperative complications have poor prognosis [17,23,24,28].…”