Case Report: Kryptonite—A Rare Case of Left-Sided Bilothorax in a Sickle Cell Patient
Bilothorax is a rare cause of an exudative pleural effusion. The diagnosis is confirmed by a pleural fluid to serum bilirubin ratio of greater than 1. Typically, bilothorax presents as a right-sided effusion due to its proximity to the liver and biliary system. Herein, we present a case of isolated...
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| Format: | Article |
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Wiley
2019-01-01
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| Series: | Case Reports in Pulmonology |
| Online Access: | http://dx.doi.org/10.1155/2019/8658343 |
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| author | Vikas D. Reddy Anas Al-Khateeb Muhammad Hussain Varun Patel Muqueet Kadri Rutwik Patel Siva Prasad Maruboyina Richard A. Miller Joseph R. DePasquale |
| author_facet | Vikas D. Reddy Anas Al-Khateeb Muhammad Hussain Varun Patel Muqueet Kadri Rutwik Patel Siva Prasad Maruboyina Richard A. Miller Joseph R. DePasquale |
| author_sort | Vikas D. Reddy |
| collection | DOAJ |
| description | Bilothorax is a rare cause of an exudative pleural effusion. The diagnosis is confirmed by a pleural fluid to serum bilirubin ratio of greater than 1. Typically, bilothorax presents as a right-sided effusion due to its proximity to the liver and biliary system. Herein, we present a case of isolated left-sided bilothorax in a 43-year-old female admitted with sickle cell crisis. Only one other case of isolated spontaneous left-sided bilothorax has been described in the literature. A thoracentesis performed on admission demonstrated greenish fluid and bilothorax was suspected, with a pleural fluid to serum bilirubin ratio greater than 1 confirming the diagnosis. A magnetic resonance cholangiopancreatography (MRCP) showed an abnormal 90-degree acute angulation in the mid-to-distal common bile duct with proximal common bile duct and intrahepatic bile ducts dilation. This was further confirmed with an endoscopic retrograde cholangiopancreatography (ERCP), which did not reveal any extravasation of contrast into the left pleural space. Ultimately, despite the use of various modalities, no definitive cause of bilothorax was identified. Postthoracentesis imaging revealed evidence of fibrothorax, a direct and permanent complication of bilothorax. The presence of an isolated left-sided bilothorax, along with the lack of a confirmed etiology, makes this case unique. |
| format | Article |
| id | doaj-art-d942fd6823b246ec8bc1ea9e9d994b43 |
| institution | Kabale University |
| issn | 2090-6846 2090-6854 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Pulmonology |
| spelling | doaj-art-d942fd6823b246ec8bc1ea9e9d994b432025-02-03T06:05:21ZengWileyCase Reports in Pulmonology2090-68462090-68542019-01-01201910.1155/2019/86583438658343Case Report: Kryptonite—A Rare Case of Left-Sided Bilothorax in a Sickle Cell PatientVikas D. Reddy0Anas Al-Khateeb1Muhammad Hussain2Varun Patel3Muqueet Kadri4Rutwik Patel5Siva Prasad Maruboyina6Richard A. Miller7Joseph R. DePasquale8Department of Internal Medicine, Saint Michael’s Medical Center, Newark, NJ, USADepartment of Pulmonary and Critical Care, Saint Michael’s Medical Center, Newark, NJ, USADepartment of Internal Medicine, Saint Michael’s Medical Center, Newark, NJ, USADepartment of Gastroenterology, Saint Michael’s Medical Center, Newark, NJ, USADepartment of Pulmonary and Critical Care, Saint Michael’s Medical Center, Newark, NJ, USADepartment of Internal Medicine, Saint Michael’s Medical Center, Newark, NJ, USADepartment of Internal Medicine, Saint Michael’s Medical Center, Newark, NJ, USADepartment of Pulmonary and Critical Care, Saint Michael’s Medical Center, Newark, NJ, USADepartment of Gastroenterology, Saint Michael’s Medical Center, Newark, NJ, USABilothorax is a rare cause of an exudative pleural effusion. The diagnosis is confirmed by a pleural fluid to serum bilirubin ratio of greater than 1. Typically, bilothorax presents as a right-sided effusion due to its proximity to the liver and biliary system. Herein, we present a case of isolated left-sided bilothorax in a 43-year-old female admitted with sickle cell crisis. Only one other case of isolated spontaneous left-sided bilothorax has been described in the literature. A thoracentesis performed on admission demonstrated greenish fluid and bilothorax was suspected, with a pleural fluid to serum bilirubin ratio greater than 1 confirming the diagnosis. A magnetic resonance cholangiopancreatography (MRCP) showed an abnormal 90-degree acute angulation in the mid-to-distal common bile duct with proximal common bile duct and intrahepatic bile ducts dilation. This was further confirmed with an endoscopic retrograde cholangiopancreatography (ERCP), which did not reveal any extravasation of contrast into the left pleural space. Ultimately, despite the use of various modalities, no definitive cause of bilothorax was identified. Postthoracentesis imaging revealed evidence of fibrothorax, a direct and permanent complication of bilothorax. The presence of an isolated left-sided bilothorax, along with the lack of a confirmed etiology, makes this case unique.http://dx.doi.org/10.1155/2019/8658343 |
| spellingShingle | Vikas D. Reddy Anas Al-Khateeb Muhammad Hussain Varun Patel Muqueet Kadri Rutwik Patel Siva Prasad Maruboyina Richard A. Miller Joseph R. DePasquale Case Report: Kryptonite—A Rare Case of Left-Sided Bilothorax in a Sickle Cell Patient Case Reports in Pulmonology |
| title | Case Report: Kryptonite—A Rare Case of Left-Sided Bilothorax in a Sickle Cell Patient |
| title_full | Case Report: Kryptonite—A Rare Case of Left-Sided Bilothorax in a Sickle Cell Patient |
| title_fullStr | Case Report: Kryptonite—A Rare Case of Left-Sided Bilothorax in a Sickle Cell Patient |
| title_full_unstemmed | Case Report: Kryptonite—A Rare Case of Left-Sided Bilothorax in a Sickle Cell Patient |
| title_short | Case Report: Kryptonite—A Rare Case of Left-Sided Bilothorax in a Sickle Cell Patient |
| title_sort | case report kryptonite a rare case of left sided bilothorax in a sickle cell patient |
| url | http://dx.doi.org/10.1155/2019/8658343 |
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