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Ann Geriatr Med Res > Volume 19(4); 2015 > Article
Journal of the Korean Geriatrics Society 2015;19(4):248-253.
DOI: https://doi.org/10.4235/jkgs.2015.19.4.248    Published online December 31, 2015.
Bilious Pleural Infection via Pleurobiliary Fistula Following Percutaneous Transhepatic Gallbladder Drainage
Hye Young Lee, Ji Young Lee, Young Il Kim, Ki Sul Chang, Ji Young Yhi, Ji Yong Moon, Sang Heon Kim, Tae Hyung Kim, Jang Won Sohn, Dong Ho Shin, Ho Joo Yoon, Dong Won Park
Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea. portrayme@hanmail.net
경피적 경간 담낭배액술 이후에 발생한 흉강담도루를 통한 담즙성 흉막 감염 1예
이혜영⦁이지영⦁김영일⦁장기설⦁이지영⦁문지용⦁김상헌⦁김태형⦁손장원⦁신동호⦁윤호주⦁박동원
한양대학교 의과대학 내과학교실
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.
Key Words: Biliary fistula, Drainage, Pleural effusion
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