Abstract
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.
MeSH terms
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Aged
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Bile / diagnostic imaging
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Bile / metabolism
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Biliary Fistula / diagnostic imaging*
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Biliary Fistula / etiology
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Biliary Fistula / physiopathology
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Biliary Fistula / therapy*
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Bronchial Fistula / diagnostic imaging*
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Bronchial Fistula / etiology
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Bronchial Fistula / physiopathology
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Bronchial Fistula / therapy
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Cautery / adverse effects
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Cholangiopancreatography, Endoscopic Retrograde
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Cholestasis / diagnostic imaging
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Colonic Neoplasms / pathology*
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Combined Modality Therapy / adverse effects
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Drainage
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Duodenum / surgery
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Escherichia coli Infections / physiopathology
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Escherichia coli Infections / therapy
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Female
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Fever
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Hepatectomy / adverse effects
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Humans
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Jaundice, Obstructive / etiology
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Jaundice, Obstructive / surgery
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Liver Neoplasms / diagnostic imaging
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Liver Neoplasms / physiopathology
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Liver Neoplasms / secondary
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Liver Neoplasms / surgery*
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Radionuclide Imaging
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Stents / adverse effects
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Technetium Tc 99m Lidofenin / pharmacokinetics
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Tomography, X-Ray Computed
Substances
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Technetium Tc 99m Lidofenin