RT Journal Article SR Electronic T1 Pleural empyema secondary to perforated diverticulosis due to biliary neoplasia infiltration JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e250061 DO 10.1136/bcr-2022-250061 VO 16 IS 3 A1 Dawid de Vera, Maria Teresa A1 Prieto Cuadra, Juan Daniel A1 Domínguez Pinos, Dolores A1 Hierro Martín, Isabel YR 2023 UL http://casereports.bmj.com/content/16/3/e250061.abstract AB A long-term female smoker presented to the emergency department with cough, greenish mucus and dyspnoea, without fever. The patient also reported abdominal pain and significant weight loss in recent months. Laboratory tests showed leucocytosis with neutrophilia, lactic acidosis and a faint left lower lobe consolidation on chest X-ray, for which she was admitted to the pneumology department and started on broad-spectrum antibiotherapy. After 3 days of clinical stability, the patient deteriorated rapidly, with worsening of analytical parameters and coma. The patient died a few hours later. Given the rapid and unexplained evolution of the disease, a clinical autopsy was requested, which revealed a left pleural empyema caused by perforated diverticula by neoplastic infiltration of biliary origin.