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A case of traumatic bronchobiliary fistula is presented. It is a rare complication of liver injuries. The diagnosis can be made on the observation of biliptysis. Technetium 99m EHIDA cholescintigraphy is of great help in demonstrating the fistulous tract in these patients for early diagnosis and planning for surgical approach.

Hepatobiliary functional scintigraphy (HBFS) using 99m Tc-labeled Diethyl-IDA was tested in 84 patients suffering from various hepatic and bile duct disorders. The investigated pathologies were: gall bladder dysfunction, parital bile duct obstruction, total obstruction, hepatocellular disease, cirrhosis and drug induced cholostastis. The diagnosis accuracy of the method was found to be 95 %, and the method proved to be useful for guiding the clinician in selecting those additional investigation techniques most apt to define the etiology of the pathological condition accurately. In conclusion, the non-invasive character of the technique, its usefulness even in the presence of elevated bilirubin levels and the information yielded by HBFS make it a method of choice to be placed in the beginning of the test series liver or duct patients are submitted to.

Hepatobiliary investigation using 99mTc-diethyl-iminodiacetic acid (IDA) has permitted a new point of view about the morphological and functional investigation of the biliary-digestive anastomosis. Our clinical study concerning 31 patients (13 choledochoduodenostomies 10 hepaticojejunostomies, 6 choledochojejunostomies and 2 cholecystojejunostomies) helped to specify scintigraphic imaging (stasis in intrahepatic bile duct, reflux in stomach, strangulation phenomenon on the level of the mesocolon, incomplete or complete obstruction). The problems associated with current diagnostic procedures are discussed and we place the scintigraphic method amongst other radiologic methods (barium meal, endoscopic retrograde cholangiography and percutaneous transhepatic cholangiography). This non-invasive diagonostic procedure plays a leading part in the investigation of the biliary digestive anastomosis, and particularly in the hepatico-jejunostomies.