To evaluate the value of intracavitary contrast-enhanced ultrasound in the diagnosis of biliary-bronchial fistula after hepatocellular carcinoma ablation.

Clinical data of 1 case with biliary-bronchial fistula after hepatocellular carcinoma ablation in the Third Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed. The informed consent was obtained and the local ethical committee approval had been received. The male patient, aged 56 years, underwent ultrasound-guided hepatocellular carcinoma radiofrequency ablation in September 2010. Examination revealed the tumor was completely ablated and no recurrence was detected 1 month after ablation. Ten months after operation, the patient suffered from recurrent fever and developed coughing up of bile-stained sputum at 17 months after ablation. MRI examination indicated the formation of a bile lake at the ablation site and percutaneous catheter drainage was performed. The diagnosis was confirmed by fluoroscopic and intracavitary contrast-enhanced ultrasound examination.

The biliary fistula tract was found connected to the right chest by intracavitary contrast-enhanced ultrasound examination. After drainage the patients' symptoms were relieved. The biliary fistula tract disappeared when checked by intracavitary contrast-enhanced ultrasound but the bile lake still existed. Right hemihepatectomy was performed subsequently. The patient was cured and discharged.

Biliary-bronchial fistula is a rare complication after hepatocellular carcinoma ablation. Intracavitary contrast-enhanced ultrasound could serve as a useful complementary method for the diagnosis and treatment of biliary-bronchial fistula.