Open AccessBilothorax as a rare sign of intra-abdominal bile leak in a patient without peritonitis
Author(s) -
M. R. J. Jenkinson,
William B. Campbell,
Taylor Mb
Publication year - 2013
Publication title -
annals of the royal college of surgeons of england
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.39
H-Index - 63
eISSN - 1478-7083
pISSN - 0035-8843
DOI - 10.1308/003588413x13629960047678
Subject(s) - medicine , exploratory laparotomy , pleural effusion , peritonitis , laparotomy , fistula , surgery , diaphragm (acoustics) , effusion , radiology , physics , acoustics , loudspeaker
We present the case of a 60-year-old patient who developed a right-sided bilothorax following para-aortic lymph node sampling. Bilothorax is a very rare condition, with most of the reported cases resulting from direct flow of bile from the biliary system to the pleural space through a fistula or other defect in the diaphragm. In this case, there was no obvious communication found between peritoneal and pleural spaces. Our patient proceeded to an exploratory laparotomy following this finding in the absence of peritonitis. Bilothorax should be considered in patients who develop a progressive pleural effusion following upper gastrointestinal surgery, particularly if it involves manipulation of the biliary system.