Abstract
A 21 -year-old man, who had an operation for an amebic abscess of the liver 6 months earlier, had fever and was experiencing dyspnea and chest pain. His chest radiograph revealed pleural effusion at the right lung base. A diagnostic thoracentesis was performed and a drainage tube placed. The gross appearance and laboratory analysis of the pleural effusion suggested a biliary fistula associated with his previous operation. A hepatobiliary scan, performed with 5 mCi of Tc-99m EHIDA (Etifenin), demonstrated the presence of a pleuro-biliary fistula, which was then confirmed by a retrograde radionuclide fistulogram and an endoscopic retrograde cholangiograph. Computed tomography and ultrasonography were nondiagnostic
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