Bilioptysis due to a single transcavitary thoracoabdominal gunshot wound

Nantais, Jordan; Skelhorne‐Gross, Graham; Jimenez, C Pera; Ahmed, Najma; Gomez, David

doi:10.1136/tsaco-2019-000425

Cited by 2 publications

(2 citation statements)

References 12 publications

(20 reference statements)

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“…Biliary decompression or diversion using endoscopic sphincterotomy, biliary stent placement, or nasobiliary drainage and percutaneous image-guided catheter collections alone may be successful. More definitive treatment would require surgical resection of the fistula with pulmonary segmentectomy, especially in the presence of lung injury [12][13][14][15]. Recently, more advanced and less invasive approaches are being tried including transhepatic embolization of the fistulas [16].…”

Section: Discussionmentioning

confidence: 99%

Multimodality Imaging Approach in Evaluation of Post-Traumatic Bronchobiliary Fistulas

Özdemir

Way

Gopireddy

2020

Cureus

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Post-traumatic bronchobiliary fistulas (BBF) are extremely rare with high morbidity and mortality rates. Accurate and timely diagnosis of these entities is critical for appropriate treatment, which usually requires a multidisciplinary approach. We describe two posttraumatic cases using a multimodality approach including computed tomography (CT), magnetic resonance imaging (MRI)/Magnetic Resonance Cholangiopancreatography (MRCP), and hepatobiliary scintigraphy with specific emphasis on the imaging features for each modality. Management of hepatobiliary fistulas is complex, involving extensive diagnostic work up followed by a conservative and/or surgical approach.

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Section: Discussionmentioning

confidence: 99%

Multimodality Imaging Approach in Evaluation of Post-Traumatic Bronchobiliary Fistulas

Özdemir

Way

Gopireddy

2020

Cureus

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“…Most commonly, this finding has been associated with bronchobiliary fistula that can occur as a periprocedural complication, such as following surgery 1 , 2 or procedural management of hepatocellular carcinoma. 3 , 4 , 5 Other bronchobiliary fistula cases have been described as associated with trauma, 6 , 7 liver abscess 8 or echinococcosis. 9 , 10 , 11 Cases of bilioptysis unassociated with bronchobiliary fistula are infrequently reported in the literature; often, the mechanism is attributed to capillary endothelial permeability injury that allows for bilirubin, a high‐molecular‐weight protein, to cross the endothelial membrane.…”

Section: Introductionmentioning

confidence: 99%

Bilioptysis associated with alcohol hepatitis without evidence of bronchobiliary fistula: A rare case report

Ngo

Wenger

Chee

2022

Respirology Case Reports

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The presence of bilirubin in the sputum is uncommon but, when present, is most commonly associated with the presence of bronchobiliary fistula, which could be associated with a number of underlying conditions. However, the finding of bilioptysis without bronchobiliary fistula is uncommon, with one associated mechanism postulated to involve increased capillary membrane permeability. This case report describes a patient presenting with bilioptysis while being medically managed with prednisolone for severe alcoholic hepatitis. The patient developed hospital-acquired pneumonia during her hospitalization associated with bilioptysis, resulting in progressive respiratory failure requiring ventilatory support. Alcohol-related pulmonary dysfunction alters pulmonary immune processes, leading to increased susceptibility to pulmonary infection and disrupting the basal alveolar epithelial membrane, thus increasing permeability. This patient's findings were in the absence of a bronchobiliary or bronchopleural fistula, and we hypothesize that increased capillary membrane permeability was contributory to the bilioptysis in this case.

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Bilioptysis due to a single transcavitary thoracoabdominal gunshot wound

Cited by 2 publications

References 12 publications

Multimodality Imaging Approach in Evaluation of Post-Traumatic Bronchobiliary Fistulas

Multimodality Imaging Approach in Evaluation of Post-Traumatic Bronchobiliary Fistulas

Bilioptysis associated with alcohol hepatitis without evidence of bronchobiliary fistula: A rare case report

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