Bile pulmonary embolism: report of a case and a review of the literature.

Bile emboli were found at autopsy in the small pulmonary arteries of a 68-year-old man with a past history of polyposis coli who had required percutaneous transhepatic drainage of his biliary tree because of an obstructing ampullary carcinoma. A communication between the biliary tract and a hepatic vein was shown to be due to the catheter. Eight previously reported cases of bile pulmonary emboli have been found. All but one had a clear history of hepatic trauma or intrahepatic abscess. Bile pulmonary embolism is a rare, occasionally fatal, complication of fistulous communication between the biliary tree and the hepatic venous system.