Delayed diagnosis of bronchobiliary fistula complicating a pediatric living donor liver transplantation: a case report
Bronchobiliary fistula (BBF) is a very rare condition in children. Only a few pediatric BBF cases have been reported, in the context of a ruptured hydatid cyst or liver abscess. BBF after living donor liver transplantation (LDLT) has not been reported in the pediatric literature. We report a 7-year-...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Society for Transplantation
2023-12-01
|
| Series: | Korean Journal of Transplantation |
| Subjects: | |
| Online Access: | http://www.ekjt.org/journal/view.html?doi=10.4285/kjt.23.0044 |
| _version_ | 1797362355916505088 |
|---|---|
| author | Vipul Gautam Vikram Kumar Shaleen Agarwal Subhash Gupta |
| author_facet | Vipul Gautam Vikram Kumar Shaleen Agarwal Subhash Gupta |
| author_sort | Vipul Gautam |
| collection | DOAJ |
| description | Bronchobiliary fistula (BBF) is a very rare condition in children. Only a few pediatric BBF cases have been reported, in the context of a ruptured hydatid cyst or liver abscess. BBF after living donor liver transplantation (LDLT) has not been reported in the pediatric literature. We report a 7-year-old female child with Wilson disease, who developed BBF post-LDLT. She had a clinically uneventful course in the immediate post-transplant period. She was readmitted on postoperative day (POD) 75 with a productive cough and respiratory difficulty, which was diagnosed as bilioptysis secondary to BBF. Endoscopic retrograde cholangiopancreaticography was attempted but failed. Exploratory laparotomy showed a fistula from the strictured biliary anastomotic site to the right thoracic cavity; it was excised, and a Roux-en-Y hepaticojejunostomy was performed. She tolerated the procedure well and remained clinically well on follow-up through POD 185. BBF is extremely rare in children. This is the first case report of BBF in a child following LDLT. BBF requires a high index of suspicion for a timely intervention to prevent subsequent complications. |
| first_indexed | 2024-03-08T16:06:50Z |
| format | Article |
| id | doaj.art-dba9bfd5a8b9409a91c05df4e0d69853 |
| institution | Directory Open Access Journal |
| issn | 2671-8790 |
| language | English |
| last_indexed | 2024-03-08T16:06:50Z |
| publishDate | 2023-12-01 |
| publisher | Korean Society for Transplantation |
| record_format | Article |
| series | Korean Journal of Transplantation |
| spelling | doaj.art-dba9bfd5a8b9409a91c05df4e0d698532024-01-08T05:34:02ZengKorean Society for TransplantationKorean Journal of Transplantation2671-87902023-12-0137429329810.4285/kjt.23.0044kjt.23.0044Delayed diagnosis of bronchobiliary fistula complicating a pediatric living donor liver transplantation: a case reportVipul Gautam0Vikram Kumar1Shaleen Agarwal2Subhash Gupta3Department of Pediatric Hepatology, Centre for Liver and Biliary Sciences, Max Super Speciality Hospital, New Delhi, IndiaDepartment of Pediatric Hepatology, Centre for Liver and Biliary Sciences, Max Super Speciality Hospital, New Delhi, IndiaDepartment of Liver Transplant Surgery, Centre for Liver and Biliary Sciences, Max Super Speciality Hospital, New Delhi, IndiaDepartment of Liver Transplant Surgery, Centre for Liver and Biliary Sciences, Max Super Speciality Hospital, New Delhi, IndiaBronchobiliary fistula (BBF) is a very rare condition in children. Only a few pediatric BBF cases have been reported, in the context of a ruptured hydatid cyst or liver abscess. BBF after living donor liver transplantation (LDLT) has not been reported in the pediatric literature. We report a 7-year-old female child with Wilson disease, who developed BBF post-LDLT. She had a clinically uneventful course in the immediate post-transplant period. She was readmitted on postoperative day (POD) 75 with a productive cough and respiratory difficulty, which was diagnosed as bilioptysis secondary to BBF. Endoscopic retrograde cholangiopancreaticography was attempted but failed. Exploratory laparotomy showed a fistula from the strictured biliary anastomotic site to the right thoracic cavity; it was excised, and a Roux-en-Y hepaticojejunostomy was performed. She tolerated the procedure well and remained clinically well on follow-up through POD 185. BBF is extremely rare in children. This is the first case report of BBF in a child following LDLT. BBF requires a high index of suspicion for a timely intervention to prevent subsequent complications.http://www.ekjt.org/journal/view.html?doi=10.4285/kjt.23.0044bronchobiliary; fistula; liver; transplant; children |
| spellingShingle | Vipul Gautam Vikram Kumar Shaleen Agarwal Subhash Gupta Delayed diagnosis of bronchobiliary fistula complicating a pediatric living donor liver transplantation: a case report Korean Journal of Transplantation bronchobiliary; fistula; liver; transplant; children |
| title | Delayed diagnosis of bronchobiliary fistula complicating a pediatric living donor liver transplantation: a case report |
| title_full | Delayed diagnosis of bronchobiliary fistula complicating a pediatric living donor liver transplantation: a case report |
| title_fullStr | Delayed diagnosis of bronchobiliary fistula complicating a pediatric living donor liver transplantation: a case report |
| title_full_unstemmed | Delayed diagnosis of bronchobiliary fistula complicating a pediatric living donor liver transplantation: a case report |
| title_short | Delayed diagnosis of bronchobiliary fistula complicating a pediatric living donor liver transplantation: a case report |
| title_sort | delayed diagnosis of bronchobiliary fistula complicating a pediatric living donor liver transplantation a case report |
| topic | bronchobiliary; fistula; liver; transplant; children |
| url | http://www.ekjt.org/journal/view.html?doi=10.4285/kjt.23.0044 |
| work_keys_str_mv | AT vipulgautam delayeddiagnosisofbronchobiliaryfistulacomplicatingapediatriclivingdonorlivertransplantationacasereport AT vikramkumar delayeddiagnosisofbronchobiliaryfistulacomplicatingapediatriclivingdonorlivertransplantationacasereport AT shaleenagarwal delayeddiagnosisofbronchobiliaryfistulacomplicatingapediatriclivingdonorlivertransplantationacasereport AT subhashgupta delayeddiagnosisofbronchobiliaryfistulacomplicatingapediatriclivingdonorlivertransplantationacasereport |