Abstract
A 32 year-old man complained of fever and stomachache and was admitted to our hospital for further examination. Chest-abdominal CT showed a large mass of liver and liver abscess was susupected. Also pulmonary abscess was found and had a continuity with liver abscess. Percutaneous liver abscess drainage was performed and we drainaged “anchovy paste”-like pus from the abscess. Consequently we performed cavity enhancement and the contrast medium flowed into right lung and bronchus, and the diagnosis was hepatobronchial fistula. With the elevation of antibody against ameba, we diagnosed amebic liver abscess. After antibiotic treatment, we performed operation to resect the abscess and close the fistula. We made anetro-axial thoracotomy at the fifth intercostal space. The adhesion was not so strong, and middle lobectomy was performed. The fistula was already closed because of fibrosis due to the inflammation, so we covered there with pericardial fat pad. The patient recovered uneventfully after the operation. Hepatobronchial fistula is rarely seen in japan, and we report a case and review of the literature.
