Endoscopic Treatment with a Cuffed Prosthesis for Esophago-tracheal Fistula without Esophageal Stricture in a Patient with Malignant Lymphoma

Abstract

Bronchobiliary fistula (BBF) is a rare disorder, defined as opening of a passage between the bronchial tree and the biliary tract and presence of bile in the sputum (biloptysis). BBF usually occurs either in the congenital form or following multiple causes, including mainly thoracoabdominal trauma, liver abscess, parasitic liver disease, choledocholithiasis, and post operative biliary stenosis. The cardinal clinical features were respiratory symptoms, jaundice, and cholangitis. Management of fistula is often very difficult and can be associated with high morbidity and mortality rates. Early recognition and proper management are essential to avoid a fatal outcome. To date, surgery has been favored as the most efficient therapeutic option, although percutmeous approaches, and more recently, endoscopic sphincterotomy and stent insertion, have succeeded in resolving certain kind of BBF. We are reporting a case of BBF secondary to hepatic resection of hepatocelluar carcinoma which was managed by endoscopic retrograde biliary stenting for keeping optimal bile drainage and surgical operation for resection of recurred tumor and removal of subphrenic abscess, (Korean J Gastrointest Endosc 17: 220-224, 1997)