Li Tian-Yu, Zhang Zhi-Bo
Department of Pediatric Surgery, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China.
World J Clin Cases. 2019 Apr 6;7(7):881-890. doi: 10.12998/wjcc.v7.i7.881.
Congenital bronchobiliary fistula is a rare developmental abnormality with an abnormal fistula between the respiratory system and biliary tract. The aim of this report is to analyze and summarize the clinical features and experience of diagnosing and treating congenital bronchobiliary fistula (CBBF) occurring in the neonatal period.
The onset of symptoms was 3 d after birth in our patient with progressive cyanosis and respiratory distress, and a large amount of green fluid was noticed in her respiratory secretion. We performed computed tomography (CT), fiberoptic bronchoscopy, and cholangiography to make a diagnosis, as well as fistulography with a bronchoscope for the first time. These examinations provided us with valuable images to make a correct diagnosis. The fistula was dissected and removed with excellent results. Surgical removal of the fistula was successful, and the baby recovered well and was discharged. She has been followed for 4 mo without any signs of discomfort.
The main symptom of CBBF is bile-like sputum. CT, bronchoscopy, fistulography, and intraoperative cholangiography can provide important evidence for diagnosis. Surgical resection of the fistula is the first choice of treatment.
先天性支气管胆管瘘是一种罕见的发育异常，其特点是呼吸系统与胆道之间存在异常瘘管。本报告的目的是分析和总结新生儿期先天性支气管胆管瘘（CBBF）的临床特征以及诊断和治疗经验。
我们的患者出生后3天出现症状，表现为进行性发绀和呼吸窘迫，且在其呼吸道分泌物中发现大量绿色液体。我们进行了计算机断层扫描（CT）、纤维支气管镜检查和胆管造影以明确诊断，并且首次使用支气管镜进行了瘘管造影。这些检查为我们提供了有价值的图像以做出正确诊断。瘘管被分离并切除，效果良好。手术成功切除瘘管，婴儿恢复良好并出院。她已接受随访4个月，无任何不适迹象。
CBBF的主要症状是胆汁样痰液。CT、支气管镜检查、瘘管造影和术中胆管造影可为诊断提供重要依据。手术切除瘘管是首选治疗方法。
