Biliopleural fistula as a complication of percutaneous biliary drainage: experimental evidence for pleural inflammation. 1988

C Strange, and M L Allen, and P N Freedland, and J Cunningham, and S A Sahn
Department of Medicine, Medical University of South Carolina, Charleston 29425.

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.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010994 Pleura The thin serous membrane enveloping the lungs (LUNG) and lining the THORACIC CAVITY. Pleura consist of two layers, the inner visceral pleura lying next to the pulmonary parenchyma and the outer parietal pleura. Between the two layers is the PLEURAL CAVITY which contains a thin film of liquid. Parietal Pleura,Visceral Pleura,Pleura, Parietal,Pleura, Visceral
D010995 Pleural Diseases Diseases involving the PLEURA. Disease, Pleural,Diseases, Pleural,Pleural Disease
D010996 Pleural Effusion Presence of fluid in the pleural cavity resulting from excessive transudation or exudation from the pleural surfaces. It is a sign of disease and not a diagnosis in itself. Effusion, Pleural,Effusions, Pleural,Pleural Effusions
D010998 Pleurisy INFLAMMATION of PLEURA, the lining of the LUNG. When PARIETAL PLEURA is involved, there is pleuritic CHEST PAIN. Pleuritis,Pleurisies,Pleuritides
D011817 Rabbits A burrowing plant-eating mammal with hind limbs that are longer than its fore limbs. It belongs to the family Leporidae of the order Lagomorpha, and in contrast to hares, possesses 22 instead of 24 pairs of chromosomes. Belgian Hare,New Zealand Rabbit,New Zealand Rabbits,New Zealand White Rabbit,Rabbit,Rabbit, Domestic,Chinchilla Rabbits,NZW Rabbits,New Zealand White Rabbits,Oryctolagus cuniculus,Chinchilla Rabbit,Domestic Rabbit,Domestic Rabbits,Hare, Belgian,NZW Rabbit,Rabbit, Chinchilla,Rabbit, NZW,Rabbit, New Zealand,Rabbits, Chinchilla,Rabbits, Domestic,Rabbits, NZW,Rabbits, New Zealand,Zealand Rabbit, New,Zealand Rabbits, New,cuniculus, Oryctolagus
D002404 Catheterization Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from INTUBATION in that the tube here is used to restore or maintain patency in obstructions. Cannulation,Cannulations,Catheterizations
D002779 Cholestasis Impairment of bile flow due to obstruction in small bile ducts (INTRAHEPATIC CHOLESTASIS) or obstruction in large bile ducts (EXTRAHEPATIC CHOLESTASIS). Bile Duct Obstruction,Biliary Stasis,Bile Duct Obstructions,Biliary Stases,Cholestases,Duct Obstruction, Bile,Duct Obstructions, Bile,Obstruction, Bile Duct,Obstructions, Bile Duct,Stases, Biliary,Stasis, Biliary
D004322 Drainage The removal of fluids or discharges from the body, such as from a wound, sore, or cavity.

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