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Pleuro-biliary fistula from a ruptured choledochal cyst
I R Ramnarine1, A K Mulpur, M J McMahon
1Department of Thoracic surgery, Yorkshire Heart Centre, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK. ianrramnarine@hotmail.com
Summary
A ruptured intrahepatic choledochal cyst caused a rare pleuro-biliary fistula and pleural empyema. Surgical treatment was successful, highlighting rare hepatobiliary complications.
Area of Science:
- Hepatobiliary surgery
- Thoracic surgery
- Gastroenterology
Background:
- Intrahepatic choledochal cysts (ICC) are congenital biliary dilatations.
- Complications of ICC typically involve biliary obstruction, cholangitis, or pancreatitis.
- Rupture into the thoracic cavity is an exceptionally rare event.
Observation:
- A case of ICC rupture through the diaphragm was observed.
- This resulted in a pleuro-biliary fistula and right-sided pleural empyema.
- The patient underwent surgical intervention for these complications.
Findings:
- Successful surgical management of a pleuro-biliary fistula secondary to ICC rupture.
- Demonstration of a rare pathway for biliary-pleural communication.
- Resolution of right pleural empyema following surgical repair.
Implications:
- Highlights the potential for severe, uncommon complications from intrahepatic choledochal cysts.
- Underscores the importance of considering rare hepatobiliary-pleural fistulas in diagnosing pleural effusions.
- Emphasizes the role of surgical intervention in managing complex biliary-pleural communications.