Bronchobiliary Fistula and Bile Pneumonitis after Transcatheter Arterial Chemoembolization and Hepatic Surgery for Hepatocellular Carcinoma: Report of A Case

肝癌患者經肝切除手術及動脈導管化學栓塞後併發膽道支氣管瘻管及膽汁性肺炎： 病例報告

王振源(Jann-Yuan Wang) ； 李麗娜(Li-Na Lee) ； 張逸良(Yih-Leong Chang)

《胸腔醫學》 17卷1期 (2002/03) Pp. 40-44

摘要

局部膽汁鬱積和膽道支氣管瘻管是肝切除手術及動脈導管化學栓塞後罕見之併發症。一位因肝癌而曾經接受過兩次局部肝切除手術和動脈導管化學栓塞的七十七歲男性病人，因為氣促以及咳嗽中帶有膽汁而住院接受治療。檢查結果高度懷疑有膽道支氣管瘻管，隨即安排手術切除。但兩個月後，病人仍因為上述症狀復發及膽汁性肺炎導致呼吸衰竭而死亡。文章中將討論膽汁性肺炎初期和末期之影像學檢查之變化，並且探討膽道支氣管瘻管及膽汁性肺炎發生之原因以及臨床表現。

關鍵字

膽道支氣管瘻管 ； 局部膽汁鬱積 ； 膽汁性肺炎 ； 動脈導管化學栓塞 ； 肝切除手術

並列摘要

Biloma and bronchobiliary fistula (BBF) are rare complications of transcatheter arterial chemoembolization (TACE) or hepatic surgery. A 77-year-old man, who had undergone TACE and hepatic surgery for hepatocellular carcinoma twice, was admitted due to biliptysis and dyspnea. A BBF was suspected and then resected. The patient died of respiratory failure two months later, because of recurrent biliptysis and bile pneumonitis. We herein show the radiologic findings of bile pneumonitis at the initial and late stages, and review the causes and clinical manifestations of BBF and bile pneumonitis.

並列關鍵字

bronchobiliary fistula ； biloma ； bile pneumonitis ； transcatheter arterial chemoembolization ； hepatic surgery