J Korean Geriatr Soc.  2015 Dec;19(4):248-253. 10.4235/jkgs.2015.19.4.248.

Bilious Pleural Infection via Pleurobiliary Fistula Following Percutaneous Transhepatic Gallbladder Drainage

Affiliations
  • 1Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea. portrayme@hanmail.net

Abstract

A pleurobiliary fistula is an abnormal communication between the biliary system and the pleural space. It has rarely been reported after percutaneous transhepatic gallbladder drainage (PTGBD). Here, we report the case of an 88-year-old man with bilious pleural infection via pleurobiliary fistula following PTGBD. The patient had a fever, dyspnea and right pleuritic chest pain. The PTGBD was performed 2 months prior to treat acute cholecystitis with large gallstones. Chest radiography demonstrated a right pleural effusion and a computed tomography of the abdomen showed a pleurobiliary fistula tract associated with the previous PTGBD. A drainage tube was inserted into the right pleural effusion, and the bilious pleural fluid infected with Escherichia coli was drained. Careful approach to PTGBD procedure and reducing duration of catheter placement should prevent fistula formation. As a rare complication of PTGBD, practitioners should be aware of the potential of pleural infection by a pleurobiliary fistula tract.

Keyword

Biliary fistula; Drainage; Pleural effusion

MeSH Terms

Abdomen
Aged, 80 and over
Biliary Fistula
Biliary Tract
Catheters
Chest Pain
Cholecystitis, Acute
Drainage*
Dyspnea
Escherichia coli
Fever
Fistula*
Gallbladder*
Gallstones
Humans
Pleural Effusion
Radiography
Thorax
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