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Bronchobiliary fistula caused by diaphragmatic invasion of a hepatic tumour
  1. Alireza Nathani1,
  2. Maxwell Alley1,
  3. Aakash Modi1,
  4. Sunil Narayan2,
  5. Scott H Beegle1
  1. 1Department of Medicine, Division of Pulmonary and Critical Care, Albany Medical Center, Albany, New York, USA
  2. 2Department of Radiology, Albany Medical Center, Albany, New York, USA
  1. Correspondence to Dr Alireza Nathani, alireza.nathani{at}


A 71-year-old man presented with a productive cough consisting of yellow fluid. He had previously been treated for pneumonia without resolution in his symptoms. Sputum was tested for bilirubin using a urine dipstick given its similar appearance to bile, which was positive. Hepatobiliary scintigraphy scan revealed uptake of radiotracer in the right lower lobe of the lung. Endoscopic retrogade cholangiopancreatography confirmed diagnosis of a bronchobiliary fistula. The patient had a stent placed in the common bile duct promoting anterograde bile flow with complete resolution of symptoms.

  • biliary intervention
  • GI-stents
  • cancer intervention
  • respiratory system
  • pneumonia (respiratory medicine)
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  • Contributors AN: Primary author. Admitted the patient to the hospital and decided to pursue writing this interesting case report. Wrote the history as well as discussion portion of the case. Supervised other contributors. MA: Medical student. Assisted in writing history and physical findings. Did background research on the topic. SN: Contributed with high quality images. SB: Senior faculty. Reviewed entire case and made edits.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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