Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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A Case of Cholethorax following Percutaneous Transhepatic Cholangioscopy

경피경간 담도내시경술 이후에 발병한 담즙흉 1예

  • Park, Chan Sung (Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Lee, Soon Jung (Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Do, Gi Won (Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Oh, Ssang Yong (Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Cho, Hyun (Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Kim, Min Su (Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Hong, Il Ki (Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Bang, Sung Jo (Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Jegal, Yang Jin (Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Ahn, Jong-Joon (Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Seo, Kwang Won (Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine)
  • 박찬성 (울산대학교 의과대학 울산대학교병원 내과학교실) ;
  • 이순정 (울산대학교 의과대학 울산대학교병원 내과학교실) ;
  • 도기원 (울산대학교 의과대학 울산대학교병원 내과학교실) ;
  • 오쌍용 (울산대학교 의과대학 울산대학교병원 내과학교실) ;
  • 조현 (울산대학교 의과대학 울산대학교병원 내과학교실) ;
  • 김민수 (울산대학교 의과대학 울산대학교병원 내과학교실) ;
  • 홍일기 (울산대학교 의과대학 서울아산병원 핵의학교실) ;
  • 방성조 (울산대학교 의과대학 울산대학교병원 내과학교실) ;
  • 제갈양진 (울산대학교 의과대학 울산대학교병원 내과학교실) ;
  • 안종준 (울산대학교 의과대학 울산대학교병원 내과학교실) ;
  • 서광원 (울산대학교 의과대학 울산대학교병원 내과학교실)
  • Received : 2008.06.18
  • Accepted : 2008.07.14
  • Published : 2008.08.30
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Abstract

Cholethorax (bilious pleural effusion) is an extravasation of bile into the thoracic cavity via a pleurobiliary fistula (and also a bronchobiliary fistula). It is an extremely rare complication of thoraco-abdominal injuries. It can be caused by congenital anomaly and also by hepatobiliary trauma, severe infection or iatrogenic procedures. The definitive diagnosis is made with aspiration of bilious fluid from the pleural space during thoracentesis, by finding a fistulous tract during endoscopic retrograde cholangiopancreatography (ERCP) or cholagioscopy, or with finding an abnormal pleural accumulation of radioisotope during hepatobiliary nuclear imaging. Its symptoms include coughing, fever, dyspnea and pleuritc chest pain. Herein we report on a case of cholethorax following performance of percutaneous transhepatic cholangioscopy (PTCS) to remove incidentally discovered common bile duct (CBD) stones.

담즙흉은 담도 또는 담낭과 흉강 사이에 형성된 누공을 통해 담즙이 흉강으로 누출되어 흉수의 형태로 관찰되는 흉막염의 일종으로, 주로 흉강-복부 외상과 관련된 매우 드문 합병증이며 그동안 국내에는 담즙흉에 대한 문헌보고가 없었다. 이에 저자들은 최근 외상 후 흉막성 흉통과 호흡곤란을 호소하였고 담도결석 제거를 위한 경피경간담도내시경술 이후에 흉수가 발생한 환자에서 담즙흉으로 진단된 환자 1예를 경험하였기에 보고한다.

Keywords

References

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