Abstract
A 45 year-old male who had had recurrent epigastralgia and hemoptysis suddenly expectorated biliary fluid. He had suffered from right hypochondralgia at age 5, had cholecystectomy at 29 and papilloplasty at 31.
On Nov. 11, 1978, thoraco-abdominal exploration was performed. The base of the left lung was completely adherent to the diaphragm and here there was an abscess cavity which contained gallstones and bile. It was found that the subphrenic abscess which communicated with the dilated hepatic duct of the left lobe of the liver had broken through the diaphragm into the left lower lobe bronchus. Partial resection of the lung tissue and Roux-en-Y hepato-jejunostomy with T-tube decompression were carried out. 1 month later choledochotomy was performed and intrahepatic gallstones were removed. Thereafter he had an uneventful recovery.
