Bile leak post laparoscopic cholecystectomy

Case contributed by Frank Gaillard
Diagnosis certain

Presentation

Abdominal distension weeks following laparoscopic cholecystectomy.

Patient Data

Age: 50 years
Gender: Male

CT Intravenous cholangiogram

ct

Cholecystectomy with clips in the right upper quadrant. The biliary tree opacifies with contrast (Biliscopin) without dilatation. Extensive intra-abdominal fluid is present with pooling of contrast near the porta hepatis in keeping with a bile leak (confirmed). 

Case Discussion

Although CT intravenous cholangiograms are no longer commonly performed (at least not in most institutions) the ability to demonstrate positive contrast excreted in bile does have some uses. 

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