Pleurobiliary fistula caused by catheter in intrahepatic biliary tract

Abstract

In almost all cases of bronchobiliary fistula, sputum with bile is present but not in pleurobiliary fistula. Pleurobiliary fistula is seen secondary to malignancy or surgery. Bile accumulates in pleural space and causes bilious irritation followed by recurrent pneumonia. In this study, a case of pacreatic head tumor, underwent intrahepatic biliary tract catheter three times, was evaluated. The case was diagnosed with chest x-ray, computerized tomography and biochemical analysis of pleural effusion. Pleurobiliary fistula and information from the literature are presented.

Keywords

• Empyema, pleurobiliary fistula, intrahepatic catheter

İntrahepatik safra yollarındaki katetere bağlı gelişen plevrobiliyer fistül

Abstract

Bronkobiliyer fistüllü hemen hemen tüm olgularda safralı balgam mevcutken, plevrobilier fistülde ise safralı balgam gözükmemektedir. Plevrobilier fistül, malignite veya geçirilmiş cerrahiye sekonder komplikasyon olarak görülebilir. Safra plevral boşlukta birikmekte ve safra tahrişine sekonder pnömonit sıklıkla görülebilir. Bu çalışmada inoperabıl pankreas başı tümörü tanısıyla intrahepatik safra yollarına 3 kez kateter takılan olgu tartışıldı. Olgunun tanısı, akciğer grafisi, bilgisayarlı tomografisi ve plevral mayinin biyokimyasal analiziyle tanısı konuldu. Plevrobilier fistül olgusu literatür bilgileri eşliğinde sunuldu.

Keywords

• Ampiyem, plevrobilier fistül, intrahepatik kateter

References

1. Singh B, Moodley J, Sheik-Gafoor MH, Dhooma N, Reddi A. Conservative management of thoracobiliary fistula. Ann Thorac Surg 2002; 73(9): 1088-91.
2. Andalkar L, Trow TK, Motroni B, Katz DS. Bronchobiliary fistula as a complication of liver metastases: diagnosis by HIDA scan. Clin Nucl Med 2004;29(3):289-91.
3. Ramnarine IR, Mulpur AK, McMahon MJ, Thorpe JA. Pleu- ro-biliary fistula from a ruptured choledochal cyst. Eur J Cardiothorac Surg 2001; 19(2): 216-8.
4. Kabiri EH, EL Maslout A, Benosman A. Thoracic rupture of hepatic hydatidosis. Ann Thorac Surg 2001; 72(8): 1883-6.
5. Kaido T, Kano M, Suzaki S, et al. Bronchobiliary fistula af- ter hepatectomy for hepatocellular carcinoma. Dig Dis Sci 2006;51(9):1117-21.
6. Posacıoğlu H, Şen S, Çıkırıkçıoğlu M, ve ark. Traumatic thoracobiliary fistulas; Diagnosis and treatment. Ulusal Travma Dergisi 2000;6(1):61-65.
7. Ivatury RR, O’Shea J, Rohman M. Post-traumatic thoraco- biliary fistula. J Trauma1984;24(4):438
8. Chua HK, Allen MS, Deschamps C, Miller DL, Pairolero PC. Bronchobiliary fistula: principles of management. Ann Thorac Surg 2000; 70(10): 1392-4.