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September 1947

TRAUMATIC BILIARY-BRONCHIAL FISTULA: With Report of Two Cases Due to War Wounds

Author Affiliations

From the Department of Surgery, University of Illinois College of Medicine.

Arch Surg. 1947;55(3):316-329. doi:10.1001/archsurg.1947.01230080322007

A BILIARY-BRONCHIAL fistula results from some disease or injury which establishes a communication between portions of the biliary and bronchial trees. Although of infrequent occurrence, such fistulas resulting from infection and abscess formation have long been recognized.1 The most common immediate cause is infection of the subphrenic space, since this location is in close proximity to both biliary and bronchial tracts. If such infections spread upward via the lymphatic vessels through the diaphragm they may invade adherent lung tissue and eventually drain spontaneously through a bronchus. Bronchial fistulas are reported to occur in about 10 to 12 per cent of all cases of subphrenic abscess.2 Similarly, suppurative lesions of the liver may drain via a bronchus after becoming adherent to the diaphragm in the absence of a true subphrenic abscess. Amebic abscesses and echinococcic cysts of the liver, especially when secondarily infected, may thus eventuate in a bronchial

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