Delayed Presentation of Cholethorax Following Hepatic Microwave Ablation and Resection in a Patient With Metastatic Rectal Cancer

Wong, Jennifer; Dincer, Erhan; Keenan, Joseph C.; Cho, Roy J.

doi:10.1097/lbr.0000000000000586

Journal of Bronchology &Amp; Interventional Pulmonology

2019

DOI: 10.1097/lbr.0000000000000586

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Delayed Presentation of Cholethorax Following Hepatic Microwave Ablation and Resection in a Patient With Metastatic Rectal Cancer

Jennifer Wong

Erhan Dincer

Joseph C. Keenan

et al.

Abstract: FIGURE 2. Right pleural effusion and thoracentesis. Demonstration of large right-sided pleural effusion (A) and appearance of the pleural fluid postthoracentesis (B).FIGURE 1. A-C, Magnetic resonance imaging of the abdomen showing multiple T2 hyperintense liver lesions, improvement in size of liver lesions after treatment with FOLFOX 2 months later, recurrence of liver lesions 1 year after initial magnetic resonance imaging.

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2024

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

Acharya,

Kafle,

Sedhai

et al. 2024

Pulmonary Medicine

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Delayed Presentation of Cholethorax Following Hepatic Microwave Ablation and Resection in a Patient With Metastatic Rectal Cancer

Cited by 1 publication

References 8 publications

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

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

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