Broncho-hepatico-cutaneous fistula in a case of amoebic liver abscess. (April 2014)

• Record Type: Journal Article
• Authors: Kaur, Navneet; Maheshwari, Kavish; Gupta, Arun
• Is Part Of: Tropical doctor. Volume 44:Number 2(2014:Apr.)
• Page Start: 110
• Page End: 111
• Publication Date: 2014-04
• Subjects: Amoebic liver abscess -- pulmonary complications -- bronchohepatic fistula; Tropical medicine -- Periodicals; Medical care -- Developing countries -- Periodicals; Developing Countries -- Periodicals; Tropical Medicine -- Periodicals; Tropische geneeskunde; 616.9883
• DOI: 10.1177/0049475513518529
• Languages: English
• ISSNs: 0049-4755

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.