Bronchobiliary fistula: A rare cause of acute dyspnea in emergency department

Bronchobiliary fistula (BBF) is defined as passage of bile into the bronchus and sputum (bilioptysis or bilipty- sis) [1]. This rare disorder is associated with significant morbidity and mortality. Almost all patients with BBF present biliptysis as the first symptom and 50% of these patients also present acute dyspnea and bronchopneu- monia. About 75% of patients present chronic symptoms, productive cough, recurrent pneumonia, and bronchiec- tasis of the lower lobe. We report the case of a 37-year-old woman admitted to emergency department for acute dyspnea and bilioptysis.