Biliopleural fistula after penetrating thoracoabdominal injury: A case report

Tesfaye, Samuel; Genetu, Abraham; Tesfaye, Mahlet; Gulilat, Dereje

doi:10.1016/j.ijscr.2022.107126

Cited by 4 publications

(1 citation statement)

References 7 publications

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“…Bronchobiliary fistula (BBF) is a rare complication of infection, trauma, and complex surgical procedures, [1][2][3] which is defined as an abnormal intercommunication between the biliary tract and the bronchial tree, [4] with high mortality and morbidity rate (12.2%). [5,6] Multiple management strategies have been described in the literature including complex surgical procedures, minimally invasive techniques, and systemic treatment.…”

Section: Introductionmentioning

confidence: 99%

Bronchobiliary fistula caused after percutaneous transhepatic biliary drainage treatment: A case report

Lian,

Zhou,

Peng

et al. 2023

Medicine

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Rationale: Percutaneous transhepatic biliary drainage (PTBD) plays a significant role especially in the diagnosis and decompression of bile duct obstruction. However, it is associated with complications such as hemobilia, occlusion of drainage, bile leakage, and even bronchobiliary fistula (BBF). Patient concerns and diagnoses: We herein describe a patient with a complication of BBF caused by long-term indwelling PTBD catheters. She underwent multiple operations including bilioenteric anastomosis, hepatic left lateral lobectomy, and long-term PTBD treatment. Her symptoms were mainly cough, fever, and yellow sputum and her diagnosis was confirmed by sputum culture (bilirubin detection was positive). Interventions and outcomes: The patient recovered uneventfully by minimally invasive treatment, was discharged after 1 week of hospitalization, and the drainage tube was removed 2 weeks later. During 2 years of follow-up, no recurrence of BBF was observed. Lessons: Patients with long-term indwelling PTBD catheters for biliary tract obstruction may lead to BBF. The treatment plan of BBF is tailored to the patient’s individualized characteristics. And minimally invasive treatments might be an effective alternate way for the treatment of BBF. The accurate diagnosis, precision treatment, and multidisciplinary team play important roles in the treatment of BBF.

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Section: Introductionmentioning

confidence: 99%

Bronchobiliary fistula caused after percutaneous transhepatic biliary drainage treatment: A case report

Lian,

Zhou,

Peng

et al. 2023

Medicine

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Nonoperative management of biliopleural fistula following living‐donor liver transplantation: A case report

Kazemi,

Rasekhi,

Nazari

et al. 2023

Clinical Case Reports

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Key Clinical MessageBiliopleural fistula is a rare but serious complication after liver transplantation that should be managed nonoperatively with antibiotics, pleural drainage, decompression of high‐pressure biliary tract, or ultimately surgery in unresponsive cases.AbstractBilious pleural effusion is a rare entity often iatrogenic, following hepatobiliary surgeries and biliary interventions, and has been reported only in a limited number of patients after liver transplantation. A 5‐year‐old girl underwent living donor liver transplantation due to progressive familial intrahepatic cholestasis. At the 7th day of the postoperative course, due to increased liver enzymes and bilirubin levels and intrahepatic bile duct dilatation on sonography, Magnetic Resonance Cholangiopancreaticography followed by a liver biopsy were performed; the findings demonstrated moderate intrahepatic bile duct dilatation and moderate cellular rejection associated with mild cholestasis, respectively. The patient was therefore administered a pulse of methylprednisolone; however, due to fever, peritonitis and also sonographic evidence of infected biloma collection adjacent to the transplanted liver, the patient underwent surgery. Laparotomy and peritoneal washout were performed and a Jackson‐Pratt drain was inserted adjacent to the liver cut surface. Succeeding tachypnea on 28th post day, led to detection of right side massive pleural effusion on chest Xray and hence thoracostomy tube was inserted. A diagnosis of biliopleural fistula was established and broad‐spectrum intravenous antibiotic therapy was started, followed by cholangiography, fistula closure, and bile duct stricture ballooning and internal‐external biliary catheter insertion. The patient was discharged in generally good condition on the 50th posttransplant day. The diagnosis of biliopleural fistula is facilitated with the utilization of chest imaging and pleural fluid analysis, however, a high index of suspicion is required.

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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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Biliopleural fistula after penetrating thoracoabdominal injury: A case report

Cited by 4 publications

References 7 publications

Bronchobiliary fistula caused after percutaneous transhepatic biliary drainage treatment: A case report

Bronchobiliary fistula caused after percutaneous transhepatic biliary drainage treatment: A case report

Nonoperative management of biliopleural fistula following living‐donor liver transplantation: A case report

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

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