• Biliary fistula
• Bilioptysis
• Bronchial fistula
• Congenital
• Laparoscopy

• Congenital
• Fistula
• Pediatric
• Thoracobiliary

• Biliary Fistula/diagnostic imaging
• Biliary Fistula/etiology
• Biliary Fistula/surgery
• Bronchial Fistula/diagnostic imaging
• Bronchial Fistula/etiology
• Bronchial Fistula/surgery
• Humans
• Infant, Newborn
• Thoracic Surgery, Video-Assisted
• Tracheal Diseases/congenital
• Tracheal Diseases/surgery

There is very little published literature and none that discussed care in a neonate regarding anesthetic risk and management of neonate with congenital bronchobiliary fistula during thoracoscopy and thoracotomy. This article analyzes related risk factors and literature review from perioperative ventilation, circulation and other aspects of management.

A neonate diagnosed as congenital bronchobiliary fistula combined with severe chemical pneumonia, consolidation of the lungs, and infection was facing the risk of anaesthesia under thoracoscopy exploration surgery, who experiened more than 20 days diagnostic period before operation. Many risk factors have led to conversion from minimally invasive surgery to thoracotomy, including persistent hypoxemia, hypercapnia, difficult surgical exposure and extremly difficulty of intraoperative ventilation management. Anesthesia maintenance after conversion to open access remained problematic. Fortunately the patient showed no sign of any adverse CNS effects after 4 months of follow-up.

The most prominent anesthesia challenges are hypoxemia, increased airway resistance, impaired ventilation, and the risk of metabolic acidosis. Close cooperation among the entire neonatal medical team is the key factors in successful management of this rare case.

• Anesthesia
• CBBF
• Chemical pneumonia
• Congenital bronchobiliary fistula
• Hypercapnia
• Hypoxemia
• Neonate

Congenital bronchobiliary fistula is a rare developmental abnormality with an abnormal fistula between the respiratory system and biliary tract. The aim of this report is to analyze and summarize the clinical features and experience of diagnosing and treating congenital bronchobiliary fistula (CBBF) occurring in the neonatal period.

The onset of symptoms was 3 d after birth in our patient with progressive cyanosis and respiratory distress, and a large amount of green fluid was noticed in her respiratory secretion. We performed computed tomography (CT), fiberoptic bronchoscopy, and cholangiography to make a diagnosis, as well as fistulography with a bronchoscope for the first time. These examinations provided us with valuable images to make a correct diagnosis. The fistula was dissected and removed with excellent results. Surgical removal of the fistula was successful, and the baby recovered well and was discharged. She has been followed for 4 mo without any signs of discomfort.

The main symptom of CBBF is bile-like sputum. CT, bronchoscopy, fistulography, and intraoperative cholangiography can provide important evidence for diagnosis. Surgical resection of the fistula is the first choice of treatment.

• Congenital bronchobiliary fistula
• Neonate
• Computed tomography
• Bronchoscopy
• Fistulography
• Case report

Congenital tracheobiliary or bronchobiliary fistula is a rare developmental anomaly with a persistent communication between the biliary system and the trachea or bronchus. We report a case of a congenital tracheobiliary fistula and hypoplastic common hepatic duct associated with hypoplastic left heart syndrome in a 5-day old boy presenting with bilious endotracheal-tube secretions. The tracheobiliary fistula was treated by surgical resection. Subsequent cholangiography demonstrated dilated intrahepatic bile ducts and a residual fistulous tract with cystic proximal stump that were successfully decompressed by transhepatic drainage catheters before corrective biliary surgery.

• CT, computed tomography
• MRI, magnetic resonance imaging

• Body Burden
• Diagnostic Imaging
• Humans
• Medical Oncology/methods
• Neoplasms/diagnosis
• Pediatrics/methods
• Radiation Protection/methods
• Relative Biological Effectiveness