Koch Kathryn A. M.D.; Crump, John M. M.D.; Monteiro, Carmela B. M.D.Journal of Clinical Gastroenterology: January 1995 Case Studies: PDF Only Buy Abstract A 76-year-old white woman with ovarian adenocarcinoma developed massive biliptysis following an unexpected respiratory arrest. The possibility of active right upper quadrant disease had not been entertained until she developed this complication of a biliobronchial fistula. Because this sign had not previously been observed by any of us, it led to a comprehensive review of the topic of biliobronchial fistula. © Lippincott-Raven Publishers.