Authors: Anish Bhattacharya Koramadai Karuppuswamy Kamaleshwaran Chidambaram Natarajan Balasubramaniam Harisankar Kuruva Manohar Mohammed Labeeb Abrar Bhagwant Rai Mittal
Publish Date: 2010/07/21
Volume: 37, Issue: 10, Pages: 1994-1994
Abstract
A 22yearold male patient suffered a grade IV liver injury with haemoperitoneum in a roadside accident 2 months earlier for which laparotomy and biliary stenting were done However after a few days the stent was passed during defecation A week later the patient developed intractable cough with copious expectoration of green sputum Chest Xray showed rightsided pleural effusion with consolidation in the right lower lobe Sputum examination confirmed the presence of bile which raised the suspicion of a biliobronchial communication99mTcMebrofenin hepatobiliary scintigraphy HBS showed preserved function in the right lobe of the liver and impaired uptake in the left lobe a Static planar images from 45 min to 2 h b c showed unobstructed biliary drainage into the intestine caudally with a streak of tracer passing cranially into the chest cavity arrowhead and subsequently taking the shape of the central airways arrow Hybrid SPECT/CT imaging d e f identified radiotracer in the bronchi and trachea arrow
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