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08 September 2023: Articles

Complications of Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma: A Case Report of Bronchobiliary Fistula Development in a 68-Year-Old Man

Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents

Ta-Kai Fang A , Yung-Ning Huang A , Tung-Ying Chiang B , Xiang-bo Liu B , Yang-Bor Lu A*

DOI: 10.12659/AJCR.939195

Am J Case Rep 2023; 24:e939195

Table 1. Comparison of previously published similar case reports with our case.

Sex and ageFistulae orifice in side of lungClinical presentationDiagnostic approachesTreatment strategiesOutcomesReferences
Cough and biliptysisFeverJaundiceOther manifestation and/or comorbidity
M 52RightYesNoNoPneumonia, abdominal painChest CT revealed the previous ablated zone contained air density with air-fluid level at the peripheral portion. The cystic portion with air-fluid level were suspicious for abnormal communication between the bronchial system and biloma at the ablation zone through the thermally injured diaphragmUltrasound-guided external drainage, intravenous antibiotic therapyCured[]2
M 65RightYesYesYesPneumonia, abdominal painChest CT scan showed right lower lobe of the lung was connected to a hepatic cystic lesion and was filled with fluidPercutaneous drainageDied 2 weeks later due to progressive right lower lobe pneumonia[]12
M 53RightYesYesYesGeneral weakness, abdominal painContrast medium injected through the drainage catheter opacified the right bile ducts and right lower-lobe segmental bronchiPercutaneous transhepatic drainages, fluoroscopically guided obliterationDied 1 month later of hepatic failure and cachexia[]13
M 69RightYesNoNoPneumoniaChest X-ray demonstrated right lower-lobe pneumonia. Abdominal CT scan showed a biloma and ascitesPercutaneous transhepatic drainage, external and internal biliary stentingDied 5 months later of advanced HCC and cachexia[]14
M 68RightYesYesNoLung abscess, pleural effusionAbdominal MRI revealed a liver abscess of the S8 Segment extended into the lung cavity. Cholangiography revealed the resolution of the contrast extravasation from the biliary system (S8 of the liver) to the bronchial systemPercutaneous transhepatic drainage, ERBD, pigtail catheter drainage in the lung cavityDied months later due to sepsis and multiple organ failure

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923