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An Interesting Case of a Bilious Pleural Effusion
Christoffel van Niekerk1, Kelly Fan1, Anna Sarcon1
1Scripps Green Hospital, La Jolla, CA, USA.
Journal of Investigative Medicine High Impact Case Reports
|August 11, 2017
Summary
This case report details a rare instance of bilious pleural effusion (cholethorax) occurring after a medical procedure, not solely due to cancer spread. It highlights a unique complication following endoscopic retrograde cholangiopancreatography.
Area of Science:
- Gastroenterology
- Pulmonology
- Oncology
Background:
- Malignant pleural effusions are frequent in advanced cancers.
- Gallbladder adenocarcinoma can metastasize to the lungs, potentially causing pleural effusions.
Purpose of the Study:
- To report a unique case of bilious pleural effusion (cholethorax) post-endoscopic retrograde cholangiopancreatography (ERCP).
- To explore potential mechanisms for this rare complication.
- To review existing literature on bilious pleural effusions.
Main Methods:
- Case presentation of a patient with gallbladder adenocarcinoma and pulmonary metastases.
- Detailed description of the acute development of bilious pleural effusion after ERCP.
- Literature review of cholethorax/bilothorax cases.
Main Results:
- A patient with metastatic gallbladder cancer developed an acute bilious pleural effusion after ERCP.
- The effusion was attributed to ERCP complication rather than tumor-induced biliary-pleural fistula.
- Discussion of potential formation mechanisms for this rare event.
Conclusions:
- Bilious pleural effusion can be a rare complication of ERCP in patients with biliary and hepatic pathology.
- Distinguishing ERCP-related cholethorax from tumor-related fistulas is crucial for management.
- Further investigation into the pathogenesis of ERCP-induced cholethorax is warranted.
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