Detection of a suspected bronchobiliary fistula by hepatobiliary scintigraphy

Ann Nucl Med. 2008 Aug;22(7):641-3. doi: 10.1007/s12149-008-0154-z. Epub 2008 Aug 29.

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.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Bile / diagnostic imaging
  • Bile / metabolism
  • 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
  • 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
  • Jaundice, Obstructive / etiology
  • Jaundice, Obstructive / surgery
  • Liver Neoplasms / diagnostic imaging
  • Liver Neoplasms / physiopathology
  • Liver Neoplasms / secondary
  • Liver Neoplasms / surgery*
  • Radionuclide Imaging
  • Stents / adverse effects
  • Technetium Tc 99m Lidofenin / pharmacokinetics
  • Tomography, X-Ray Computed

Substances

  • Technetium Tc 99m Lidofenin