TY - JOUR
T1 - Biliopleural fistula as a complication of percutaneous biliary drainage
T2 - Experimental evidence for pleural inflammation
AU - Strange, C.
AU - Allen, M. L.
AU - Freedland, P. N.
AU - Cunningham, J.
AU - Sahn, S. A.
PY - 1988
Y1 - 1988
N2 - We describe 3 patients in whom biliopleural fistulae complicated percutaneous biliary drainage. All patients had complete obstruction of their biliary tree because of malignancy. Biliopleural fistulae developed as a complication of inadvertent catheter removal in 2 patients and of catheter dysfunction in the third. Early reinstitution of biliary drainage and successful drainage of the pleural space led to complete recovery in all patients. An animal model to evaluate the effects of bile in the pleural space in normal rabbits revealed rapid absorption of bilirubin, the production of a polymorphonuclear-predominant exudative effusion with extremely high LDH levels, and resolution with a macrophage influx. We conclude that biliopleural fistulae are heterogeneous in their presentation, depending upon the persistence of biliary drainage into the pleural space, the volume of exudative effusion, and the presence of suppurative complications.
AB - We describe 3 patients in whom biliopleural fistulae complicated percutaneous biliary drainage. All patients had complete obstruction of their biliary tree because of malignancy. Biliopleural fistulae developed as a complication of inadvertent catheter removal in 2 patients and of catheter dysfunction in the third. Early reinstitution of biliary drainage and successful drainage of the pleural space led to complete recovery in all patients. An animal model to evaluate the effects of bile in the pleural space in normal rabbits revealed rapid absorption of bilirubin, the production of a polymorphonuclear-predominant exudative effusion with extremely high LDH levels, and resolution with a macrophage influx. We conclude that biliopleural fistulae are heterogeneous in their presentation, depending upon the persistence of biliary drainage into the pleural space, the volume of exudative effusion, and the presence of suppurative complications.
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U2 - 10.1164/ajrccm/137.4.959
DO - 10.1164/ajrccm/137.4.959
M3 - Article
C2 - 3355006
AN - SCOPUS:0023940415
SN - 0003-0805
VL - 137
SP - 959
EP - 961
JO - American Review of Respiratory Disease
JF - American Review of Respiratory Disease
IS - 4
ER -