Bronchobiliary fistula detected with hepatobiliary scintigraphy.
Bile leakage into the thoracic cavity is a rare complication of invasive cancer. A 12-year-old boy was diagnosed with undifferentiated sarcoma of the right lobe of the liver invading the diaphragm. An extended right hepatectomy and total resection of the mass was performed, leaving a patchy tumoral invasion at the anterior diaphragmatic surface. Surgery was followed with a combined chemotherapy regimen. In the sixth postoperative month, he was readmitted with bilious expectoration. Tc-99m mebrofenin hepatobiliary scintigraphy revealed radiotracer accumulation in the right hemithorax. Bile leakage into the right thoracic cavity was diagnosed based on the hepatobiliary scintigraphic findings. For this patient; hepatobiliary scintigraphy, which is routinely used to visualize the liver and biliary tree, provided a noninvasive mean for the precise diagnosis of a bronchobiliary fistula. The fistula was then confirmed and corrected with surgery. The patient recovered uneventfully.
Berk
Fatma
F
Department of Nuclear Medicine, Kocaeli University School of Medicine, Turkey. fatmaberk@hotmail.com
Corapcioglu
Funda
F
Demir
Hakan
H
Akansel
Gür
G
Guvenc
B Haluk
BH
D001646:Bile; D001658:Biliary Fistula / Q000000981:diagnostic imaging* / Q000628:therapy; D001983:Bronchial Fistula / Q000000981:diagnostic imaging* / Q000628:therapy; D002648:Child; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery; D008297:Male; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012509:Sarcoma / Q000601:surgery; D019785:Technetium Tc 99m Disofenin
D019275:Radiopharmaceuticals; D019785:Technetium Tc 99m Disofenin