Bilioptysis: A sign of pulmonary capillary permeability injury

Abstract

B ilothorax, the presence of bi le or bil iary pigment in the thoracic cavity, is extremely rare.1 Bilothorax has been reported in infectious empyemas and most commonly as a result of hepatic trauma, 2 percutaneous bil iary drainage, bil iary obstruction, 3 and bi l iopleural fistula. 4 We describe the first case, to our knowledge, of cardiogenic pulmonary edema stained with bi l irubin as a result of massive hemolysis in the se t t ing of sys temic in f lammatory response synd rome (SIRS) and sickle cel l crisis.