A dangerous pleural effusion.
Bilothorax is a rare complication of biliary peritonitis and, if not treated promptly, can be life-threatening. We report a case of a middle-aged woman who had undergone a bilio-enteric bypass and subsequently a biliary leak developed, which finally led to intra-abdominal biliary collection and spontaneous bilothorax. The clinical course was rapid and mimicked venous thromboembolism, myocardial infarction and pulmonary oedema, which led to a delay in diagnosis and management and finally death. We high-light the fact that bilothorax, although a rare complication of biliary surgery, should always be considered as a probable cause of massive effusion and sudden-onset respiratory and cardiovascular collapse in the postoperative period. A chest X-ray and a diagnostic pleural tap can confirm the diagnosis. Once detected, an aggressive management should be instituted to prevent organ failure and death.
Basu
Somprakas
S
Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India. sombasu@hotmail.com
Bhadani
Shilpi
S
Shukla
Vijay K
VK
D001646:Bile; D002763:Cholecystectomy / Q000009:adverse effects*; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis; D010538:Peritonitis / Q000150:complications; D010996:Pleural Effusion / Q000000981:diagnostic imaging / Q000209:etiology*; D011859:Radiography; D054556:Venous Thromboembolism / Q000175:diagnosis