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Arch Iran Med. 2013;16(8): 0.
PMID: 23906257
Scopus ID: 84883242044
  Abstract View: 2336
  PDF Download: 1514

Case Report

Cholethorax (Bilious Effusion in the Thorax): An Unusual Complication of Laparoscopic Cholecystectomy

Akin Aydogan, Ersin Sukru Erden, Seckin Akkucuk*, Ramazan Davran, Ibrahim Yetim, Orhan Veli Ozkan
*Corresponding Author: Email: seckinakkucuk@gmail.com

Abstract

Cholethorax or bilious effusion in the thorax, is a rare condition in which bile passes into the pleural space from the abdominal cavity, necessitating urgent treatment. In this article, we present a case of cholethorax as a complication of laparoscopic cholecystectomy (LC). The patient underwent a LC due to the presence of a gallbladder polyp. The clip attached to the Hartman opened, and the abdominal cavity became contaminated with biliary fluid. Postoperatively, the patient experienced severe right upper quadrant pain and dyspnea. Both the posteroanterior (PA) chest radiography and thoracic computed tomography (CT) were remarkable for marked effusion in the right hemithorax. The patient underwent thoracentesis which resulted in the removal of 250 cc bilious pleural effusion. The bilirubin level of the pleural fluid was 9.1 mg/dL. Following thoracentesis, the patient experienced significant improvement in dyspnea and pain. The patient was discharged without any complications on the seventh day postoperatively. Cholethorax may occur as a result of diaphragmatic injuries secondary to a laparoscopic instrument and can be successfully treated by a thoracentesis.

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ePublished: 01 Aug 2013
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