title: Cholethorax (bilious effusion in the thorax): an unusual complication of laparoscopic cholecystectomy.
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 thoracenftesis.
authors.affiliation: Mustafa Kemal University, Faculty of Medicine, Department of General Surgery, Hatay, Turkey.
authors.forename: Akin
authors.initials: A
authors.lastname: Aydogan
authors.forename: Ersin
authors.initials: E
authors.lastname: Sukru Erden
authors.forename: Seckin
authors.initials: S
authors.lastname: Akkucuk
authors.forename: Ramazan
authors.initials: R
authors.lastname: Davran
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Yetim
authors.forename: Orhan
authors.initials: O
authors.lastname: Veli Ozkan
mesh_terms: D000328:Adult; D017081:Cholecystectomy, Laparoscopic; D006801:Humans; D008297:Male; D019300:Medical Errors / Q000009:adverse effects*; D010996:Pleural Effusion / Q000209:etiology*; D011183:Postoperative Complications / Q000209:etiology* / Q000628:therapy