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.
Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India. sombasu@hotmail.com
Somprakas
S
Basu
Shilpi
S
Bhadani
Vijay K
VK
Shukla
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