08 September 2023: Articles
Complications of Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma: A Case Report of Bronchobiliary Fistula Development in a 68-Year-Old Man
Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents
Ta-Kai Fang A , Yung-Ning Huang A , Tung-Ying Chiang B , Xiang-bo Liu B , Yang-Bor Lu A*DOI: 10.12659/AJCR.939195
Am J Case Rep 2023; 24:e939195
Table 1. Comparison of previously published similar case reports with our case.
| Sex and age | Fistulae orifice in side of lung | Clinical presentation | Diagnostic approaches | Treatment strategies | Outcomes | References | |||
|---|---|---|---|---|---|---|---|---|---|
| Cough and biliptysis | Fever | Jaundice | Other manifestation and/or comorbidity | ||||||
| M 52 | Right | Yes | No | No | Pneumonia, abdominal pain | Chest CT revealed the previous ablated zone contained air density with air-fluid level at the peripheral portion. The cystic portion with air-fluid level were suspicious for abnormal communication between the bronchial system and biloma at the ablation zone through the thermally injured diaphragm | Ultrasound-guided external drainage, intravenous antibiotic therapy | Cured | []2 |
| M 65 | Right | Yes | Yes | Yes | Pneumonia, abdominal pain | Chest CT scan showed right lower lobe of the lung was connected to a hepatic cystic lesion and was filled with fluid | Percutaneous drainage | Died 2 weeks later due to progressive right lower lobe pneumonia | []12 |
| M 53 | Right | Yes | Yes | Yes | General weakness, abdominal pain | Contrast medium injected through the drainage catheter opacified the right bile ducts and right lower-lobe segmental bronchi | Percutaneous transhepatic drainages, fluoroscopically guided obliteration | Died 1 month later of hepatic failure and cachexia | []13 |
| M 69 | Right | Yes | No | No | Pneumonia | Chest X-ray demonstrated right lower-lobe pneumonia. Abdominal CT scan showed a biloma and ascites | Percutaneous transhepatic drainage, external and internal biliary stenting | Died 5 months later of advanced HCC and cachexia | []14 |
| M 68 | Right | Yes | Yes | No | Lung abscess, pleural effusion | Abdominal MRI revealed a liver abscess of the S8 Segment extended into the lung cavity. Cholangiography revealed the resolution of the contrast extravasation from the biliary system (S8 of the liver) to the bronchial system | Percutaneous transhepatic drainage, ERBD, pigtail catheter drainage in the lung cavity | Died months later due to sepsis and multiple organ failure | |