technetium-tc-99m-lidofenin and Bronchial-Fistula

Bronchobiliary fistula (BBF) represents a rare but severe complication in patients affected by liver metastases. Although a clinical suspicion can arise when specific clinical signs, in particular biliptysis, are present, conventional imaging modalities often fail to confirm the diagnosis. We present a case of a patient affected by colon cancer with liver metastases previously treated with partial right-sided hepatectomy and multiple thermo-ablative treatments combined with chemotherapy, who manifested a septic fever associated with productive cough and biliptysis. Diagnosis of BBF was confirmed only by hepatobiliary scintigraphy with (99m)Tc-heptoiminodiacetic acid.

Topics: Aged; Bile; Biliary Fistula; Bronchial Fistula; Cautery; Cholangiopancreatography, Endoscopic Retrograde; Cholestasis; Colonic Neoplasms; Combined Modality Therapy; Drainage; Duodenum; Escherichia coli Infections; Female; Fever; Hepatectomy; Humans; Jaundice, Obstructive; Liver Neoplasms; Radionuclide Imaging; Stents; Technetium Tc 99m Lidofenin; Tomography, X-Ray Computed

Topics: Aged; Biliary Fistula; Bronchial Fistula; Female; Humans; Polycystic Ovary Syndrome; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Lidofenin

Bronchobiliary fistulas are rare, may result from infection with Echinococcus or Amebiasis, trauma, or hepatic malignancy, and present with biliptysis, the expectoration of bile. The authors present a 49-year-old woman who presented with frank biliptysis as a result of previously treated metastatic colon cancer to the liver. A hepatobiliary scan is the noninvasive diagnostic imaging test of choice for demonstration of such fistulas, and was useful in confirming the diagnosis in our patient.

Topics: Bile; Biliary Fistula; Bronchial Fistula; Female; Humans; Liver Neoplasms; Lung; Middle Aged; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Lidofenin

Topics: Aged; Biliary Fistula; Bronchial Fistula; Echinococcosis, Hepatic; Female; Humans; Imino Acids; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin

A case of bronchobiliary fistula diagnosed by 99mTc-HIDA cholescintigraphy is presented. The fistula caused by a stenosing tumor of the left hepatic duct would probably have been missed without the use of delayed views and body fluids counting which increased the specificity of scintigraphic findings.

Topics: Bile Duct Neoplasms; Biliary Fistula; Bronchial Fistula; Cholecystectomy; Cholestasis, Extrahepatic; Diagnosis, Differential; Female; Hepatic Duct, Common; Humans; Imino Acids; Mastectomy; Middle Aged; Postoperative Complications; Radionuclide Imaging; Technetium; Technetium Tc 99m Lidofenin