Dasmahapatra H K, Pepper J R
Department of Cardiovascular Surgery, Hospital for Sick Children, Toronto, Canada.
Chest. 1988 Oct;94(4):874-5. doi: 10.1378/chest.94.4.874.
We describe the management of bronchopleurobiliary fistula in a 56-year-old woman who underwent a (L) mastectomy with postoperative radio- and chemotherapy for advanced breast carcinoma and required insertion of inhabiliary Silastic stents for the relief of severe obstructive jaundice. During restaging of her carcinoma for further chemotherapy, she complained of dyspnea, right chest pain and productive cough with yellow sputum. Her chest x-ray film and thoraco-abdominal CT scan demonstrated right pleural effusion with a stent protruding through the right hemidiaphragm. The objective evidence of bile in the pleural aspirate with history of bile-stained sputum established the diagnosis of bronchopleurobiliary fistula resulting from biliary stent migration.
我们描述了一名56岁女性支气管胸膜胆瘘的治疗情况。该患者因晚期乳腺癌接受了左乳切除术，并在术后接受了放疗和化疗，因严重梗阻性黄疸需要插入胆道硅橡胶支架。在对其癌症进行进一步化疗的重新分期期间，她出现呼吸困难、右胸痛以及咳出黄色痰的症状。她的胸部X光片和胸腹CT扫描显示右侧胸腔积液，且有一个支架穿过右侧膈肌突出。胸腔穿刺抽出液中有胆汁，并有咳出胆汁样痰液的病史，这些客观证据确立了因胆道支架移位导致支气管胸膜胆瘘的诊断。
