The Teaching Point

Even if endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatic-cholangiography (PTC) are the most preferred procedures to provide the direct photographic evidence of bronchobiliary fistula (BBF), contrast-enhanced magnetic resonance cholangiography (MRC) has the advantage to be a non-invasive technique that not only ensures a definite diagnosis, but also provide anatomical and functional information about biliary tree and flow.






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From the manuscript

Spontaneous bronchobiliary fistula: Case report

Free full text article: Spontaneous bronchobiliary fistula: Case report

Abstract
Bronchobiliary fistula (BBF) is a rare condition that results from the communication between the bile ducts and the bronchial tree. It is characterized by the presence of bile in the sputum as pathognomonic symptom, and it is often associated with suspicious pneumonia. The most common causes include infections (e.g. echinococcosis), hepatobiliary surgery, blunt torso traumas, tumors and percutaneous transhepatic procedures. Opinions about BBF treatment are still controversial as it can be treated by both conservative and surgical procedures, while pharmacological treatments are only rarely used. This case report presents a patient who had been diagnosed with chronic BBF of unknown cause, underwent several ineffective conservative procedures and was at last surgically treated.






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