title: Endoscopic (-ERC) fibrin sealing and histoacryl sealing of an abscess induced bilio-hepatico-cutaneous and a bilio-hepatico-phrenico-bronchial fistulous system.
abstract: We report the case of a female patient with persisting bilio-bronchial and bilio-cutaneous fistulae originating in the right liver lobe. The causative factor was a subphrenic liver abscess which had been adequately and successfully treated. No biliary obstruction was detectable on admission. Because of her previous medical history the patient was considered to be a high surgical risk. Therefore the described endoscopic (ERC) approach was chosen. Here we describe the first successful attempt to close such a fistulous system by repeated fibrin and histoacryl-sealing through an endoscopically guided catheter. The success of this innovative procedure may be helpful, in the management of similar cases in the future.
authors.affiliation: Department of Internal Medicine I, University of Ulm.
authors.forename: G
authors.initials: G
authors.lastname: Herold
authors.forename: B
authors.initials: B
authors.lastname: Danz
mesh_terms: D001658:Biliary Fistula / Q000000981:diagnostic imaging / Q000601:surgery*; D001983:Bronchial Fistula / Q000000981:diagnostic imaging / Q000601:surgery*; D002758:Cholangiography; D017577:Cutaneous Fistula / Q000000981:diagnostic imaging / Q000601:surgery*; D004659:Enbucrilate / Q000008:administration & dosage*; D019723:Endoscopes; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage*; D005402:Fistula / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications / Q000000981:diagnostic imaging; D008100:Liver Abscess / Q000150:complications* / Q000000981:diagnostic imaging; D008107:Liver Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D009894:Opportunistic Infections / Q000150:complications / Q000000981:diagnostic imaging; D012008:Recurrence; D013369:Subphrenic Abscess / Q000150:complications* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed
chemical_list: D015718:Fibrin Tissue Adhesive; D004659:Enbucrilate