Work

Biliary Breach: A Rare Case of a Biliary Pleural Fistula Without a History of Trauma

Year: 2025

Type: article

Abstract: Biliary pleural fistulas (BPFs) are pathologic connections between the biliary tree and pleural cavity, allowing for abnormal flow of bile into the pleural space. This finding is rare and typically results from surgical procedures, such as chest tube placement, or trauma. We present the case of an 84-year-old male who initially presented with respiratory and gastrointestinal symptoms. Non-contrast CT of the chest, abdomen, and pelvis demonstrated a large right-sided empyema, which appeared to be continuous with a fluid-containing structure in the gallbladder fossa. Subsequent diagnostic workup revealed a biliary pleural fistula, which was ultimately treated with robotic cholecystectomy and fistula takedown. BPFs are rare entities; however, clinicians should consider them in the differential diagnoses of patients who present with both gastrointestinal and respiratory symptoms.

Source: Cureus

DOI: 10.7759/cureus.81286

Authors: Andrew Liepshutz, Joshua D Batista, Brooke Merdjane, Nima Khosravani, Soni Chousleb

Institutions: Florida International University, University of North Carolina at Chapel Hill, Baptist Health South Florida

Language: English

Topic: Biliary and Gastrointestinal Fistulas

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond