Biliary peritonitis caused by a leaking T-tube fistula disconnected at the point of contact with the anterior abdominal wall: a case reportReportar como inadecuado




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Journal of Medical Case Reports

, 2:302

First Online: 16 September 2008Received: 27 March 2008Accepted: 16 September 2008DOI: 10.1186-1752-1947-2-302

Cite this article as: Nikolić, M., Karthikesalingam, A., Nachimuthu, S. et al. J Med Case Reports 2008 2: 302. doi:10.1186-1752-1947-2-302

Abstract

IntroductionOperations on the common bile duct may lead to potentially serious complications such as biliary peritonitis. T-tube insertion is performed to reduce the risk of this occurring postoperatively. Biliary leakage at the point of insertion into the common bile duct, or along the fistula, can sometimes occur after T-tube removal and this has been reported extensively in the literature. We report a case where the site at which the T-tube fistula leaked proved to be the point of contact between the fistula and the anterior abdominal wall, a previously unreported complication.

Case presentationA 36-year-old sub-Saharan African woman presented with gallstone-induced pancreatitis and, once her symptoms settled, laparoscopic cholecystectomy was performed, common bile duct stones were removed and a T-tube was inserted. Three weeks later, T-tube removal led to biliary peritonitis due to the disconnection of the T-tube fistula which was recannulated laparoscopically using a Latex drain.

ConclusionThis case highlights a previously unreported mechanism for bile leak following T-tube removal caused by detachment of a fistula tract at its contact point with the anterior abdominal wall. Hepatobiliary surgeons should be aware of this mechanism of biliary leakage and the use of laparoscopy to recannulate the fistula.

Electronic supplementary materialThe online version of this article doi:10.1186-1752-1947-2-302 contains supplementary material, which is available to authorized users.

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Autor: Marko Nikolić - Alan Karthikesalingam - Senthil Nachimuthu - Tjun Y Tang - Adrian M Harris

Fuente: https://link.springer.com/







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