A Case of Cholethorax following Percutaneous Transhepatic Cholangioscopy.

Park, Chan Sung; Lee, Soon Jung; Do, Gi Won; Oh, Ssang Yong; Cho, Hyun; Kim, Min Su; Hong, Il Ki; Bang, Sung Jo; Jegal, Yang Jin; Ahn, Jong Joon; Seo, Kwang Won

doi:2008.65.2.131

Tuberc Respir Dis > Volume 65(2); 2008 > Article

Case Report

Tuberculosis and Respiratory Diseases 2008;65(2):131-136.
DOI: https://doi.org/10.4046/trd.2008.65.2.131 Published online August 1, 2008.

A Case of Cholethorax following Percutaneous Transhepatic Cholangioscopy.

Chan Sung Park, Soon Jung Lee, Gi Won Do, Ssang Yong Oh, Hyun Cho, Min Su Kim, Il Ki Hong, Sung Jo Bang, Yang Jin Jegal, Jong Joon Ahn, Kwang Won Seo

¹Department of Internal Medicine, Ulsan University Hospital, Ulsan, Korea. kwseo@uuh.ulsan.kr
²Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Abstract

Cholethorax (bilious pleural effusion) is an extravasation of bile into the thoracic cavity via a pleurobiliary fistula (and also a bronchobiliary fistula). It is an extremely rare complication of thoraco-abdominal injuries. It can be caused by congenital anomaly and also by hepatobiliary trauma, severe infection or iatrogenic procedures. The definitive diagnosis is made with aspiration of bilious fluid from the pleural space during thoracentesis, by finding a fistulous tract during endoscopic retrograde cholangiopancreatography (ERCP) or cholagioscopy, or with finding an abnormal pleural accumulation of radioisotope during hepatobiliary nuclear imaging. Its symptoms include coughing, fever, dyspnea and pleuritc chest pain. Herein we report on a case of cholethorax following performance of percutaneous transhepatic cholangioscopy (PTCS) to remove incidentally discovered common bile duct (CBD) stones.

Key Words: Biliary fistula, Pleural effusion, Bile, Cholangiography, Technetium Tc 99m Diethyl-iminodiacetic Acid