title: Broncho-hepatico-cutaneous fistula in a case of amoebic liver abscess.
abstract: Pulmonary complications occur in 7-20% of patients with amoebic liver abscess(ALA) and may present as pleural effusion, empyema, lung abscess or a bronchohepatic fistula. Rupture into a bronchus presents as sudden coughing with expectoration of chocolate-coloured sputum and is usually managed by postural drainage, bronchodilators and anti-amoebic drugs. A young boy presented with a large amoebic liver abscess of about 1 L volume which ruptured into the lung. He required surgical drainage of the liver abscess as even after intubation he was not able to maintain adequate ventilation. Following this he developed a broncho-hepatico-cutaneous fistula with drainage of 400-500 mL bile per day and bubbling of air in the abdominal drain. He underwent selective right hepatic duct cannulation with endo-papillotomy, following which the fistula closed gradually.
authors.affiliation: Professor, Department of Surgery, UCMS & GTB Hospital, University of Delhi, Delhi, India.
authors.forename: Navneet
authors.initials: N
authors.lastname: Kaur
authors.forename: Kavish
authors.initials: K
authors.lastname: Maheshwari
authors.forename: Arun
authors.initials: A
authors.lastname: Gupta
mesh_terms: D000293:Adolescent; D002404:Catheterization; D017577:Cutaneous Fistula / Q000150:complications*; D004322:Drainage; D005402:Fistula / Q000150:complications / Q000601:surgery; D006801:Humans; D008101:Liver Abscess, Amebic / Q000150:complications / Q000601:surgery*; D008297:Male; D010996:Pleural Effusion / Q000150:complications; D016896:Treatment Outcome
keywords: Amoebic liver abscess; bronchohepatic fistula; pulmonary complications