Bronchobiliary Fistula Mimicking Pneumonia: A Case Report and Diagnostic Dilemma

Bronchobiliary fistula is a rare condition where the bronchial tree and biliary tract are abnormally connected, leading to bilioptysis (bile in the sputum). It can be misdiagnosed as pneumonia due to overlapping symptoms. This case report describes a 45-year-old man with severe necrotizing gallstone pancreatitis, presenting with pneumonia-like symptoms, who was diagnosed with a bronchobiliary fistula. The case highlights the challenge of distinguishing bronchobiliary fistulas from pneumonia in patients with hepatobiliary issues. Diagnosis requires recognizing bilioptysis and using tools, such as bronchoscopy, bile testing, and imaging. Management focuses on addressing biliary obstruction.