A Case of Cholethorax Developed by Unknown Cause

Seong, Mun Hyuk; Kim, Sung Moo; Yoo, Suk Hee; Park, Woo Ri; An, Jin; Choe, Kang Hyeon; Lee, Ki Man; Kim, Si Wook

doi:10.4046/trd.2011.70.3.261

Cited by 3 publications

(1 citation statement)

References 16 publications

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“…In our case, biliothorax was the first manifestation of a bililary neoplasm, what it could be considered as unusual clinical presentation of an ampullary tumor. However, in the literature some cases of biliothorax of idiopathic etiology had been published [9]. Initial management of biliothorax consists of a combination of pleural fluid drainage, location of the PBF and biliary decompression to facilitate BPF closure by endoscopic procedures such as ERCP or percutaneous cholangiography.…”

Section: Discussionmentioning

confidence: 99%

An Unusual Case of Left-Sided Massive Biliothorax

Soler-Sempere¹

2015

Int J Respir Pulm Med

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Section: Discussionmentioning

confidence: 99%

An Unusual Case of Left-Sided Massive Biliothorax

Soler-Sempere¹

2015

Int J Respir Pulm Med

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Bilothorax: A Case Report and Systematic Literature Review of the Rare Entity

Acharya,

Kafle,

Sedhai

et al. 2024

Pulmonary Medicine

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Background. Bilothorax is defined as the presence of bile in the pleural space. It is a rare condition, and diagnosis is confirmed with a pleural fluid‐to‐serum bilirubin ratio of >1. Methods. The PubMed, Embase, Google Scholar, and CINAHL databases were searched using predetermined Boolean parameters. The systematic literature review was done per PRISMA guidelines. Retrospective studies, case series, case reports, and conference abstracts were included. The patients with reported pleural fluid analyses were pooled for fluid parameter data analysis. Results. Of 838 articles identified through the inclusion criteria and removing 105 duplicates, 732 articles were screened with abstracts, and 285 were screened for full article review. After this, 123 studies qualified for further detailed review, and of these, 115 were pooled for data analysis. The mean pleural fluid and serum bilirubin levels were 72 mg/dL and 61 mg/dL, respectively, with a mean pleural fluid‐to‐serum bilirubin ratio of 3.47. In most cases, the bilothorax was reported as a subacute or remote complication of hepatobiliary surgery or procedure, and traumatic injury to the chest or abdomen was the second most common cause. Tube thoracostomy was the main treatment modality (73.83%), followed by serial thoracentesis. Fifty‐two patients (51.30%) had associated bronchopleural fistulas. The mortality was considerable, with 18/115 (15.65%) reported death. Most of the patients with mortality had advanced hepatobiliary cancer and were noted to die of complications not related to bilothorax. Conclusion. Bilothorax should be suspected in patients presenting with pleural effusion following surgical manipulation of hepatobiliary structures or a traumatic injury to the chest. This review is registered with CRD42023438426.

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Bilious Pleural Infection via Pleurobiliary Fistula Following Percutaneous Transhepatic Gallbladder Drainage

Lee

Kim

et al. 2015

J Korean Geriatr Soc

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A pleurobiliary fistula is an abnormal communication between the biliary system and the pleural space. It has rarely been reported after percutaneous transhepatic gallbladder drainage (PTGBD). Here, we report the case of an 88-year-old man with bilious pleural infection via pleurobiliary fistula following PTGBD. The patient had a fever, dyspnea and right pleuritic chest pain. The PTGBD was performed 2 months prior to treat acute cholecystitis with large gallstones. Chest radiography demonstrated a right pleural effusion and a computed tomography of the abdomen showed a pleurobiliary fistula tract associated with the previous PTGBD. A drainage tube was inserted into the right pleural effusion, and the bilious pleural fluid infected with Escherichia coli was drained. Careful approach to PTGBD procedure and reducing duration of catheter placement should prevent fistula formation. As a rare complication of PTGBD, practitioners should be aware of the potential of pleural infection by a pleurobiliary fistula tract.

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A Case of Cholethorax Developed by Unknown Cause

Cited by 3 publications

References 16 publications

An Unusual Case of Left-Sided Massive Biliothorax

An Unusual Case of Left-Sided Massive Biliothorax

Bilothorax: A Case Report and Systematic Literature Review of the Rare Entity

Bilious Pleural Infection via Pleurobiliary Fistula Following Percutaneous Transhepatic Gallbladder Drainage

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