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biliary leak, status post laparoscopic cholecystectomy

Kang PK - MedPix

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: biliary leak, status post laparoscopic cholecystectomy

History: s/p recent laparoscopic cholecystectomy, now with fevers and abdominal pain

Findings: Axial CT with intravenous and oral contrast material demonstrates a large fluid collection predominantly within the porta hepatis around multiple surgical clips consistent with prior cholecystectomy. More fluid is seen around the right lobe of the liver and more inferiorly within the right paracolic gutter. Peritoneal fat around the fluid collection demonstrates stranding suggestive of inflammation. Planar and SPECT images after the administration of Tc99m-disofenin IV demonstrates large amount of abnormal radiotracer accumulation within the area corresponding to the large fluid collection seen on the CT images, consistent with a biliary leak. Note that a tubular area of radiotracer uptake leading from the large collection apparently outside the body is the collection within the percutaneous drainage tube placed prior to the scintigraphic study.

Ddx: biliary leak, status post laparoscopic cholecystectomy

Exam: fever right upper quadrant abdominal tenderness

No MeSH data available.


Axial CT with intravenous and oral contrast material demonstrates a large fluid collection predominantly within the porta hepatis around multiple surgical clips consistent with prior cholecystectomy.  More fluid is seen around the right lobe of the liver and more inferiorly within the right paracolic gutter.  Peritoneal fat around the fluid collection demonstrates stranding suggestive of inflammation.
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MPX1073_synpic16494: Axial CT with intravenous and oral contrast material demonstrates a large fluid collection predominantly within the porta hepatis around multiple surgical clips consistent with prior cholecystectomy. More fluid is seen around the right lobe of the liver and more inferiorly within the right paracolic gutter. Peritoneal fat around the fluid collection demonstrates stranding suggestive of inflammation.


biliary leak, status post laparoscopic cholecystectomy

Kang PK - MedPix

Axial CT with intravenous and oral contrast material demonstrates a large fluid collection predominantly within the porta hepatis around multiple surgical clips consistent with prior cholecystectomy.  More fluid is seen around the right lobe of the liver and more inferiorly within the right paracolic gutter.  Peritoneal fat around the fluid collection demonstrates stranding suggestive of inflammation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1073&req=5

MPX1073_synpic16494: Axial CT with intravenous and oral contrast material demonstrates a large fluid collection predominantly within the porta hepatis around multiple surgical clips consistent with prior cholecystectomy. More fluid is seen around the right lobe of the liver and more inferiorly within the right paracolic gutter. Peritoneal fat around the fluid collection demonstrates stranding suggestive of inflammation.

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: biliary leak, status post laparoscopic cholecystectomy

History: s/p recent laparoscopic cholecystectomy, now with fevers and abdominal pain

Findings: Axial CT with intravenous and oral contrast material demonstrates a large fluid collection predominantly within the porta hepatis around multiple surgical clips consistent with prior cholecystectomy. More fluid is seen around the right lobe of the liver and more inferiorly within the right paracolic gutter. Peritoneal fat around the fluid collection demonstrates stranding suggestive of inflammation. Planar and SPECT images after the administration of Tc99m-disofenin IV demonstrates large amount of abnormal radiotracer accumulation within the area corresponding to the large fluid collection seen on the CT images, consistent with a biliary leak. Note that a tubular area of radiotracer uptake leading from the large collection apparently outside the body is the collection within the percutaneous drainage tube placed prior to the scintigraphic study.

Ddx: biliary leak, status post laparoscopic cholecystectomy

Exam: fever right upper quadrant abdominal tenderness

No MeSH data available.