Case Series on Hepato-bronchial Fistula and Liver Abscess in Nigerian Patients

Abstract

Background: Hepato-bronchial fistula is an abnormal communication between the liver parenchyma and the bronchial tree through the diaphragm. It is a rare complication of Liver abscess. Methods: The study aimed to investigate a case series report on a 69-year-old woman and a 70-year-old male with hepato-bronchial fistula, a rare complication of Liver abscess. And summaries of various cases of liver abscess managed in our health facility between 2022 to 2024. The case notes of the patients were retrieved, and their clinical history, physical examination findings and relevant imaging and laboratory results were summarised. Results: The two patients with hepatobronchial fistula were both elderly (a male and a female). The female had hypoproteinemia, probably from malnutrition. While case two was an elderly man with background type diabetes mellitus and colorectal carcinoma. Both patients presented with expectoration of anchovy sauce paste. They were chronically ill-looking and had tender hepatomegaly. Their antibody-based enzyme-linked immunosorbent assay (ELISA) for Entamoeba histolytica results were positive. The abdominal ultrasound reported a solitary homogenous hypoechoic round lesion in the right lobes of the liver, suggestive of Liver abscess. Conclusions: Hepato-bronchial fistula, though a very rare occurrence, may complicate amoebic liver abscess and should be looked out for in patients expectorating anchovy sauce-like paste.