Acute Lethal Hepato-Bronchial Fistula: Emergency Perioperative Management Using Two Single-Lumen Endotracheal Tubes for Lung Isolation
Olumuyiwa A. Bamgbade1*, Sikiru A. Adebayo2, Ajibola U. Otegbeye3, Fidelia B. Alawa4, Olajumoke O. Lawal5, Jennifer R. Okpeki6, Sedofia K. Hoggar7, Obianuju S. Ossai8, Precious M. Samuel-Ogunnoiki9, Juliet M. Mulenga10, Lysiane M. Atcham Amougou11 and Grace G. Gitonga12
1 Department of Anesthesiology, University of British Columbia, Vancouver, Canada.
2 Department of Surgery, University College Hospital, Ibadan, Nigeria.
3 Department of Anaesthesia, University College Hospital, Ibadan, Nigeria.
4 Department of Medicine, University of Port Harcourt, Port Harcourt, Nigeria.
5 Department of Nursing, University College Hospital, Ibadan, Nigeria
6 Department of Anaesthesia, Federal Medical Centre, Asaba, Nigeria.
7 Department of Medicine, University of Ghana, Accra, Ghana.
8 Department of Research, Salem Anaesthesia Pain Clinic Surrey, Vancouver, BC, Canada.
9 Department of Medicine, Babcock University, Ikenne, Nigeria.
10 Department of Nursing, Ministry of Health, Lusaka, Zambia.
11 Department of Public Health, Ministry of Public Health, Yaounde, Cameroon.
12 Department of Medicine, University of Nairobi, Nairobi, Kenya.
*Corresponding Author: Olumuyiwa A. Bamgbade, Department of Anesthesiology, University of British Columbia, Vancouver, Canada. Postal address- POBox 75085, Surrey, BC, V4A 0B1, Canada. Phone- +1-7786286600
DOI: https://doi.org/10.58624/SVOAMR.2024.02.018
Received: November 19, 2024 Published: December 09, 2024
Abstract
Background: Hepato-bronchial fistula (HBF) is a rare complication of hepatic abscess. The usual atypical presentation poses diagnostic and management challenges to clinicians.
Case Presentation: This is a case report of acute lethal HBF in an adult who underwent successful surgical management at a hospital in Nigeria. Anaesthetic management was complicated by the lack of appropriate double-lumen endotracheal tubes or bronchial blockers for lung isolation. Therefore, two small cuffed ID=5mm endotracheal tubes (ETT) were used for lung isolation, with a good outcome.
Conclusion: This report highlights the safe option of using two small ETTs for perioperative lung isolation, especially in resource-limited settings. The report describes the challenging and meticulous perioperative management of HBF.
Keywords: Hepato-bronchial fistula, Hepato-pleural fistula, Broncho-biliary fistula, Hepatic abscess, Single lumen endobronchial tube, Lung isolation
Citation: Bamgbade OA, Adebayo SA, Otegbeye AU, Alawa FB, Lawal OO, Okpeki JR, Hoggar SK, Ossai OS, Samuel-Ogunnoiki PM, Mulenga JM, Atcham Amougou LM, Gitonga GG. Acute Lethal Hepato-Bronchial Fistula: Emergency Perioperative Management Using Two Single-Lumen Endotracheal Tubes for Lung Isolation. SVOA Medical Research 2024, 2:3, 56-59. doi: 10.58624/SVOAMR.2024.02.018