Cutaneous bronchobiliary fistula following laparotomy for ruptured hydatid cyst of the liver

Cutaneous bronchobiliary fistula is a rare and an uncommon but severe complication of the hydatid cyst of the liver. Treatment has traditionally been surgical resection. We hereby describe a case of a 55-year-old male who had undergone exploratory laparotomy with peritoneal lavage for ruptured right hepatic lobe hydatid cyst 1 year back. During the post-operative course, the patient came to the outpatient department of our hospital complaining of leakage of purulent exudate through a cutaneous opening located above the umbilicus in midline, pain in the right hypochondrium radiating to the right hemithorax, malaise, fever and chronic productive cough. Fistulography revealed a convoluted cavity communicating with a residual cystic cavity on the right hepatic lobe with the right bronchial tree. We observed communication with the intrahepatic canaliculi. Computed tomographic scan revealed a fistulous tract on the anterior liver border through the abdominal wall. There were no post-treatment complications. The patient is asymptomatic.