A Case of Biliary Fistula Diagnosed by Sonazoid-enhanced Ultrasonography

Our study presents a clinical case encompassing a 69-year-old female patient who received radiotherapy as a therapeutic intervention for an unresectable malignancy affecting the pancreas. Subsequent to an incident involving the dislodgement of the Percutaneous Transhepatic Cholangiography and Drainage (PTCD) tube during the patient's hospitalization, a successful ultrasonography-guided PTCD procedure was performed. Moreover, Sonazoid-enhanced ultrasonography, facilitated through the PTCD tube, was employed to ascertain the presence of a biliary fistula. The fistula was ultimately remedied through the timely implementation of ultrasound-guided abdominal drainage. Conclusion: Sonazoid contrast-enhanced ultrasonic cholangiography conducted via a PTCD tube offers a convenient and secure modality for visualizing parameters such as fistula length, fistula width, and fractional flow.