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      [Bronchobiliary fistula].

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          Abstract

          A 57-year-old woman with congenital syphilis had a productive cough, fever, cholecystolithiasis, and paralytic ileus. She had a 30-year history of recurrent bronchitis accompanied by yellowish serous sputum. A chest radiograph showed bilateral infiltrates resulting from aspiration pneumonia, and a reduction in volume of the right middle and right lower lobes. After recovering from paralytic ileus, she still had fever and biliptysis. Bronchoscopy revealed bile filling the right basal bronchi. Emergency laparotomy and throacotomy revealed a gall stone, splenomegaly, marked atrophy of the right lobe of the liver, and adhesion between the right pleura and the diaphragm. A T-tube cholangiogram showed that the right hepatic duct communicated with the right basal bronchus. Despite ligation of the right hepatic duct, biliptysis continued. The patient died due to rapidly progressing hepatorenal failure. Syphilis gummosa due to congenital syphilis was suspected as a cause of the bronchobiliary fistula, but was not confirmed pathologically. The surgical specimen showed only nonspecific fibrosis with calcification. Bronchobiliary fistula is rare in Japan; we know of only 6 other reported cases.

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          Author and article information

          Journal
          Nihon Kyobu Shikkan Gakkai Zasshi
          Nihon Kyobu Shikkan Gakkai zasshi
          0301-1542
          0301-1542
          Jun 1996
          : 34
          : 6
          Affiliations
          [1 ] Department of Internal Medicine, Arao Municipal Hospital, Kumamoto, Japan.
          Article
          8741536
          acc05729-b518-407a-b3e3-5800111ef8e8
          History

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