Oct 11, 2023

Massive Hemothorax Caused by Removal of Percutaneous Transhepatic Abscess Drainage Tube for Bile Leak After Subtotal Cholecystectomy: A Case Report

Posted by in category: biotech/medical

New case report worth reading! A patient underwent subtotal cholecystectomy for severe cholecystitis. Post-op he developed jaundice and abscess requiring percutaneous transhepatic drainage (PTAD).

Shock and massive hemothorax occurred after removal of the PTAD tube. The cause was bleeding from the liver at the PTAD site. The patient required emergency hemostasis and embolization. This highlights the need for extreme care when handling PTAD tubes after complicated gallbladder surgery.

A 59-year-old man with a past medical history of gallstones was diagnosed with acute cholecystitis and received antibiotic treatment. He was discharged after ten days of hospitalization and was due to undergo laparoscopic cholecystectomy. Three months later, however, he had to be readmitted due to a recurrence of acute cholecystitis. Subsequently, laparoscopic reconstituting subtotal cholecystectomy was performed because Inflammation of the gallbladder was severe. At the first postoperative outpatient visit, the patient reported obstructive jaundice, and computed tomography (CT) scan revealed fluid collection in the hepatic bed and a missed common bile duct stone. Percutaneous transhepatic abscess drainage (PTAD) was performed on admission, and endoscopic stone removal was attempted the following day but was challenging due to a periampullary diverticulum.

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