A patient underwent the procedure shown above four days ago but returns with fever and abdominal pain. Labs show a leukocytosis and elevated bilirubin, alkaline phosphatase, and gamma-glutamyl transferase. A trans-abdominal ultrasound shows a contained collection of fluid in the gallbladder fossa.Challenge: What went wrong?
Image shown under GNU Free Documentation License, from Wikipedia.
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2 comments:
biloma/biliary injury
yes!
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Chole
This is most likely a bile leak. Large loculated collections should be percutaneously drained with radiologic guidance; ERCP may define the leak and allow stent placement.
Source: UpToDate.
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