A Case of Cholethorax Developed by Unknown Cause.

Seong, Mun Hyuk; Kim, Sung Moo; Yoo, Suk Hee; Park, Woo Ri; An, Jin Young; Choe, Kang Hyeon; Lee, Ki Man; Kim, Si Wook

doi:2011.70.3.261

Tuberc Respir Dis > Volume 70(3); 2011 > Article

Case Report

Tuberculosis and Respiratory Diseases 2011;70(3):261-265.
DOI: https://doi.org/10.4046/trd.2011.70.3.261 Published online March 1, 2011.

A Case of Cholethorax Developed by Unknown Cause.

Mun Hyuk Seong, Sung Moo Kim, Suk Hee Yoo, Woo Ri Park, Jin Young An, Kang Hyeon Choe, Ki Man Lee, Si Wook Kim

¹Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea. kimlee@chungbuk.ac.kr
²Department of Thoracic and Cardiovascular Surgery, Chungbuk National University College of Medicine, Cheongju, Korea.

Abstract

Cholethorax is a bilious pleural effusion caused by a pleurobiliary fistula or leakage of bile into the pleural space. Most cases of cholethorax arise from a complication of abdominal trauma, hepatobiliary infection, or invasive procedures or surgery of hepatobiliary system. However, we experienced a case of a patient with cholethorax of unknown origin. There was no evidence of pleurobiliary fistula or leakage of bile from the hepatobiliary system although we examined the patient with various diagnostic tools including chest and abdominal computed tomography, endoscopic retrograde cholangiopancreatography, tubography, bronchofiberscopy, hepatobiliary scintigraphy and video-assisted thoracoscopic surgery. Herein we report a case of cholethorax for which the specific cause was not identified. The patient was improved by percutaneous drainage of pleural bile.

Key Words: Bile, Biliary Fistula, Pleural Effusion, Diaphragm