Bilothorax or Cholethorax is the accumulation of bilious effusion in the thorax. It is a rare condition in which bile passes into the pleural space from the abdominal cavity, necessitating urgent treatment. This artic...Bilothorax or Cholethorax is the accumulation of bilious effusion in the thorax. It is a rare condition in which bile passes into the pleural space from the abdominal cavity, necessitating urgent treatment. This article aims to present a case of bilothorax treated successfully in our institute and review the literature on this topic to better understand this medical problem and the best ways of dealing with it. We presented in this article a case of bilothorax after an attempt of biliary drainage in a known pancreatic cancer patient and the way we managed it. We concluded about the importance of the early recognition of this medical problem and the necessity of aggressive and early management to prevent further morbidities and mortality.展开更多
We read with great interest the case report by Zhang et al describing unusual complications after endoscopic ultrasound-guided hepaticogastrostomy(EUSHGS)in a patient with pancreatic cancer.The patient developed dark ...We read with great interest the case report by Zhang et al describing unusual complications after endoscopic ultrasound-guided hepaticogastrostomy(EUSHGS)in a patient with pancreatic cancer.The patient developed dark green urine,bile-colored pleural effusion,and ascites,suggesting bile leak and possible biliaryvascular fistula.We believe the complication profile is more consistent with transdiaphragmatic bile leakage during segment 2 puncture,as microperforation near the diaphragm can explain bilothorax.Device selection for fistula dilation and stent type may also have contributed.High pleural fluid-to-serum bilirubin ratios further support the diagnosis of bile leak,with urinary discoloration likely reflecting systemic absorption.This rare case highlights the need for refined techniques,careful puncture site selection,and dedicated devices to enhance safety in EUS-HGS.展开更多
文摘Bilothorax or Cholethorax is the accumulation of bilious effusion in the thorax. It is a rare condition in which bile passes into the pleural space from the abdominal cavity, necessitating urgent treatment. This article aims to present a case of bilothorax treated successfully in our institute and review the literature on this topic to better understand this medical problem and the best ways of dealing with it. We presented in this article a case of bilothorax after an attempt of biliary drainage in a known pancreatic cancer patient and the way we managed it. We concluded about the importance of the early recognition of this medical problem and the necessity of aggressive and early management to prevent further morbidities and mortality.
文摘We read with great interest the case report by Zhang et al describing unusual complications after endoscopic ultrasound-guided hepaticogastrostomy(EUSHGS)in a patient with pancreatic cancer.The patient developed dark green urine,bile-colored pleural effusion,and ascites,suggesting bile leak and possible biliaryvascular fistula.We believe the complication profile is more consistent with transdiaphragmatic bile leakage during segment 2 puncture,as microperforation near the diaphragm can explain bilothorax.Device selection for fistula dilation and stent type may also have contributed.High pleural fluid-to-serum bilirubin ratios further support the diagnosis of bile leak,with urinary discoloration likely reflecting systemic absorption.This rare case highlights the need for refined techniques,careful puncture site selection,and dedicated devices to enhance safety in EUS-HGS.
