A case of biliopleural fistula in a patient with hepatocellular carcinoma

Jeffrey R Lewis; Helen S Te; Brian Gehlbach; Aytekin Oto; Jennifer Chennat; Smruti R Mohanty

doi:10.1038/nrgastro.2009.34

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A case of biliopleural fistula in a patient with hepatocellular carcinoma

Journal article

Peer reviewed

A case of biliopleural fistula in a patient with hepatocellular carcinoma

Jeffrey R Lewis, Helen S Te, Brian Gehlbach, Aytekin Oto, Jennifer Chennat and Smruti R Mohanty

Nature reviews. Gastroenterology & hepatology, Vol.6(4), pp.248-251

04/2009

DOI: 10.1038/nrgastro.2009.34

PMID: 19347016

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Abstract

A 66-year-old white man with a history of cryptogenic cirrhosis complicated by hepatocellular carcinoma, ascites and hepatic encephalopathy presented with a productive cough and pleuritic chest pain on his right side. He underwent transarterial chemoembolization for hepatocellular carcinoma 6 months before presentation. The patient had a history of coronary artery disease, type 2 diabetes mellitus and hypertension. Medical history and physical examination, laboratory investigations, diagnostic thoracentesis, bacterial culture and Gram staining studies, abdominal MRI with magnetic resonance cholangiopancreatography, endoscopic retrograde cholangiopancreatography, infused chest CT and examination of the thorax during open thoracotomy. Biliopleural fistula with connections between the right pleural space and a branch of the right intrahepatic biliary tree. Antibiotics, placement and removal of a chest tube, endoscopic retrograde cholangiopancreatography to guide biliary sphincterotomy with placement and removal of a hepatic-duct stent, open thoracotomy with decortication, percutaneous transhepatic cholangiography and placement of a catheter.

Biliary Fistula - diagnosis

Biliary Fistula - therapy

Humans

Cholangiopancreatography, Endoscopic Retrograde

Liver Neoplasms - complications

Respiratory Tract Fistula - complications

Male

Respiratory Tract Fistula - therapy

Thoracotomy

Respiratory Tract Fistula - diagnosis

Biliary Fistula - complications

Carcinoma, Hepatocellular - complications

Aged

Cholangiopancreatography, Magnetic Resonance

Details

Title: Subtitle: A case of biliopleural fistula in a patient with hepatocellular carcinoma
Creators: Jeffrey R Lewis - University of Chicago Medical Center, Chicago, IL 60637, USA
Helen S Te
Brian Gehlbach
Aytekin Oto
Jennifer Chennat
Smruti R Mohanty
Resource Type: Journal article
Publication Details: Nature reviews. Gastroenterology & hepatology, Vol.6(4), pp.248-251
Publisher: England
DOI: 10.1038/nrgastro.2009.34
PMID: 19347016
ISSN: 1759-5045
eISSN: 1759-5053
Language: English
Date published: 04/2009
Academic Unit: Neurology; Pulmonary, Critical Care, and Occupational Medicine; Internal Medicine
Record Identifier: 9984020711502771

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6 Times Cited - Web of Science