Bronchobiliary fistulae as a complication of untreated pulmonary hydatid cyst presenting with bilioptysis: A report of two cases

Hepato-thoracic cystic echinococcosis transit. Clinical features, postoperative complications and hospital mortality. A systematic review

BACKGROUND

Hepato-thoracic hydatid transit (HTT) is an evolutionary complication of hepatic cystic echinococcosis. This study aimed to report the available evidence regarding postoperative complications (POC) and hospital mortality (HM).

METHODS

Systematic review. Studies related to HTT were included. Searches were performed in Trip Database, SciELO, BIREME-BVS, WoS, PubMed, EMBASE and SCOPUS.

PRIMARY OUTCOMES

POC and HM.

SECONDARY OUTCOMES

publication date, origin and designs, number of patients, cyst type, hospital stance, treatments; and methodological quality (MQ) of studies applying MInCir-T and MInCir-Pr2 scales. Descriptive statistics, weighted means (WM) and their comparison using least squares logistic regression, and meta-analysis of prevalence of POC and HM were applied.

RESULTS

604 studies were retrieved (101 met selection criteria, representing 1020 patients). WM age: 42.6 years, 58.3 % male. Reports are mainly from Spain (19.8 %) and Turkey (17.8 %). With a WM of 18.3 days of hospital stance, it was verified 28.9 % of POC, 12.6 % needed re-interventions, and 9.7 % died. MQ of studies: 9.1 ± 1.9 (MInCir-T) and 13.2 ± 2.9 (MInCir-Pr2). Comparing the behavior of variables in two periods (1983-2002 vs. 2003-2024), statistically significant differences were observed in POC, HM, and reinterventions.

CONCLUSION

HTT is associated with high POC, and significant HM, despite the passage of time.

Bronchobiliary fistula caused after percutaneous transhepatic biliary drainage treatment: A case report

RATIONALE

Percutaneous transhepatic biliary drainage (PTBD) plays a significant role especially in the diagnosis and decompression of bile duct obstruction. However, it is associated with complications such as hemobilia, occlusion of drainage, bile leakage, and even bronchobiliary fistula (BBF).

PATIENT CONCERNS AND DIAGNOSES

We herein describe a patient with a complication of BBF caused by long-term indwelling PTBD catheters. She underwent multiple operations including bilioenteric anastomosis, hepatic left lateral lobectomy, and long-term PTBD treatment. Her symptoms were mainly cough, fever, and yellow sputum and her diagnosis was confirmed by sputum culture (bilirubin detection was positive).

INTERVENTIONS AND OUTCOMES

The patient recovered uneventfully by minimally invasive treatment, was discharged after 1 week of hospitalization, and the drainage tube was removed 2 weeks later. During 2 years of follow-up, no recurrence of BBF was observed.

LESSONS

Patients with long-term indwelling PTBD catheters for biliary tract obstruction may lead to BBF. The treatment plan of BBF is tailored to the patient's individualized characteristics. And minimally invasive treatments might be an effective alternate way for the treatment of BBF. The accurate diagnosis, precision treatment, and multidisciplinary team play important roles in the treatment of BBF.

Multiple Hepatic Hydatid Cysts With Cysto-Biliary Communication and Broncho-Biliary Fistula: A Pediatric Case Report

Hydatid cyst disease is a health problem in some developing countries occurring in groups with permanent contact with dogs. It is a parasitic disease caused by Echinococcus Granulosus. The liver is the most common organ infected. If not treated appropriately; it may lead to developing life-threatening complications. Its rupture into bile ducts is the most frequent one, while hepatopulmonary fistula is a rare complication. We discuss the case of a child presenting those 2 complications as we emphasize the importance of early diagnosis and the role of the radiologist.