Broncho-biliary fistula caused by a left hydatic cyst

Abstract Broncho-biliary fistula (BBF) of hydatid origin is a rare complication that occurs due to an abnormal connection between the biliary tract and the bronchial tree affecting three levels: abdominal, diaphragmatic, and thoracic. We report the case of a 34-year-old female patient with a recent history of jaundice. She was evaluated with a thoracoabdominal CT scan due to biliptysis and left basal pneumonia resistant to antibiotics revealing a hydatid cyst in the left lobe of the liver, measuring 60x82 mm, complicated by a type IB BBF according to Mestiri's classification. She underwent surgery via laparotomy alone, allowing control of all lesions. Radiological control one month postoperatively showed regression of the lesions. BBF of hydatid origin is rare, and left-sided localization is even rarer. The treatment is primarily surgical, and the choice of the surgical approach must be well adapted to the lesions at different levels, especially considering the type of BBF.