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  • Title: Broncho-hepatico-cutaneous fistula in a case of amoebic liver abscess.
    Author: Kaur N, Maheshwari K, Gupta A.
    Journal: Trop Doct; 2014 Apr; 44(2):110-1. PubMed ID: 24401543.
    Abstract:
    Pulmonary complications occur in 7-20% of patients with amoebic liver abscess(ALA) and may present as pleural effusion, empyema, lung abscess or a bronchohepatic fistula. Rupture into a bronchus presents as sudden coughing with expectoration of chocolate-coloured sputum and is usually managed by postural drainage, bronchodilators and anti-amoebic drugs. A young boy presented with a large amoebic liver abscess of about 1 L volume which ruptured into the lung. He required surgical drainage of the liver abscess as even after intubation he was not able to maintain adequate ventilation. Following this he developed a broncho-hepatico-cutaneous fistula with drainage of 400-500 mL bile per day and bubbling of air in the abdominal drain. He underwent selective right hepatic duct cannulation with endo-papillotomy, following which the fistula closed gradually.
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