Detection of a suspected bronchobiliary fistula by hepatobiliary scintigraphy

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 presen...

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Bibliographic Details
Published in:Annals of nuclear medicine 2008-08, Vol.22 (7), p.641-643
Main Authors: Annovazzi, Alessio, Viceconte, Giovanni, Romano, Luisa, Sciuto, Rosa, Maini, Carlo L.
Format: Article
Language:English
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
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Description
Summary: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.
ISSN:0914-7187
1864-6433
DOI:10.1007/s12149-008-0154-z