Posttraumatic bronchobiliary fstulae due to foreign body remnants after a road trafc injury: a case report

Seyed‑alagheband, Seyed‑ahmad and Shahmoradi, Mohammad‑kazem and Shekouhi, Ramin (2021) Posttraumatic bronchobiliary fstulae due to foreign body remnants after a road trafc injury: a case report. J Med Case Reports.

Preview

Text 1-s2.0-S2405857221000358-main.pdf Download (342kB) | Preview

Abstract

Background: Bronchobiliary fstula is an extremely rare disease that involves abnormal communication between a hepatic segment and bronchial tree. It is mostly caused by untreated hydatid cyst, liver abscess, iatrogenic stenosis, and, rarely, trauma. Case presentation: We experienced an extremely rare case of bronchobiliary fstula after motor vehicle accident. A 15‑year‑old Persian boy visited our clinic with chief complaints of persistent pleuritic chest pain, productive cough, weight loss, and fever for 2 months. Coronavirus disease 2019 reverse transcription polymerase chain reaction test was negative. Chest X‑ray revealed hazy opacifcation of right lower lobe. Bronchoalveolar lavage for acid‑fast bacillus came back negative. Thoracoabdominal computed tomography scan revealed a collection in segment VIII of the liver communicating with another 13 × 5 cm multiloculated collection in the lower lobe of the right lung, with air foci within the collection. Right posterolateral thoracotomy was performed with the impression of bronchobiliary fstula. Drainage of hepatic collection with debridement, diaphragmatic repair, and open decortication of lung followed by resection of the involved segment of the right lung was performed. Histopathologic evaluations revealed abscess formation in pulmonary tissue, and many multinucleated giant cells were seen that appear to be due to foreign body remnants after previous laparotomy surgery. The foreign body seemed to be the remnants of Surgicel absorbable hemostat. Conclusions: Herein, we report an extremely rare case of a posttraumatic bronchobiliary fstula caused by remnants of Surgicel hemostatic agent. Bronchobiliary fstula is mainly caused by untreated hydatid cyst, liver abscess, iatro‑ genic stenosis, and, rarely, trauma. Migration and erosion of oxidized regenerated cellulose through the diaphragm seems to be the causative factor of bronchobiliary fstula in this patient.

Actions (login required)

View Item