Song Z L
Zhonghua Wai Ke Za Zhi. 1989 May;27(5):269-71, 316.
Eight cholangio-thoracic fistula patients were seen from 1981 to 1987 in our hospital. The clinical features of the cases were classified into four types, i.e. bronchobiliary fistula (BBF, 3 cases), bronchopleurobiliary fistula (BPBF, 2 cases), pleurobiliary fistula (PBF, 2 cases) and pericardiobiliary fistula (PCBF, 1 case). In addition to a history of cholangitis or cholelithiasis and continuous or intermittent secondary biliary tract infection, the principle manifestations of BBF included: acute, subacute or chronic biliary empyema; biliary pneumonia or biliary lung abscess; and biliptysis. The empyema perforating into trachea, bronchus, pericardium and large vessels in the thoracic cavity may result in serious consequences. Asphyxiation, pericardial tamponade and abrupt massive intrathoracic hemorrhage may also be fatal. It is often difficult to locate the fistula by bronchoscopy, however the bile found in the respiratory tract may suggest BBF. Surgical management of BBF and PCBF are discussed.
1981年至1987年期间，我院共收治8例胆管-胸壁瘘患者。这些病例的临床特征分为四种类型，即支气管-胆管瘘（BBF，3例）、支气管-胸膜-胆管瘘（BPBF，2例）、胸膜-胆管瘘（PBF，2例）和心包-胆管瘘（PCBF，1例）。除了有胆管炎或胆石症病史以及持续性或间歇性继发性胆道感染外，BBF的主要表现包括：急性、亚急性或慢性胆源性脓胸；胆源性肺炎或胆源性肺脓肿；以及胆汁咳出。脓胸穿破进入气管、支气管、心包和胸腔内大血管可能会导致严重后果。窒息、心包填塞和胸腔内突然大量出血也可能致命。通过支气管镜检查常常难以定位瘘口，然而在呼吸道中发现胆汁可能提示存在BBF。文中讨论了BBF和PCBF的外科治疗方法。
