Bronchobiliary fistula treated with histoacryl embolization under bronchoscopic guidance: A case report

A 56-year-old woman presented with bile-tinged sputum for one year. Five years ago, she was diagnosed with hepatocellular carcinoma. She was treated with five hepatic arterial chemotherapies, two radiofrequency ablations, four chemoembolizations, and a right lobectomy of the liver. Two years ago, a liver abscess with biliary stricture occurred and was treated with endoscopic biliary drainage and balloon dilatation. On admission, bronchoscopy suggested a bronchobiliary fistula in the anterobasal segment of the right lower lobar bronchus. Fluorography showed a fistulous tract between the right lower lobar bronchus and the liver abscess pocket. We performed histoacryl embolization under bronchoscopic guidance and the bile-tinged sputum resolved. However, biliary obstruction and hepatic failure followed and the patient expired three months later. We report a case of a bronchobiliary fistula managed with a bronchoscopic approach.