Role of cholescintigraphy with single-photon emission computerized tomography-computed tomography in detecting bronchobiliary fistula: Unusual complication of a common disease

Abstract

Bronchobiliary fistula (BBF) was first described by Peacock in 1850. [1] Bilioptysis is one of the cardinal symptoms. Therefore, the diagnosis is based on symptoms as well as clinical history. Congenital malformations are a rare etiology for BBF; however, acquired etiologies are more common. Pathogenesis involves increased local pressure or infectious condition resulting from infected hydatid cyst, amebic liver abscess, liver trauma, or neoplasm. [2,3] The disease may lead to deferent pulmonary complications, such as recurrent chemical or bacterial pneumonitis, mediastinitis, bronchiolitis, or bronchiectasis. [4] Timely, accurate diagnosis and treatment are critical to the successful outcome. Herein, we describe a rare case of cyst-biliary communication secondary to a hydatid cyst of the liver, associated with BBF and diagnosed by hepatobiliary scintigraphy and exact localization by single-photon emission computerized tomography-computed tomography (SPECT-CT). The functional nature of hepatobiliary scintigraphy enabled the diagnosis and the extent of BBF.