Liver specific contrast in bile leak from laparoscopic cholecystectomy
Presentation
Abdominal pain and distension after laparoscopic cholecystectomy. No jaundice.
Patient Data
20min post liver-specific C+
Leak of liver-specific contrast in gallbladder fossa.
Note the excretion of the contrast in kidneys.
Case Discussion
A 20 year old woman underwent laparoscopic cholecystectomy for cholecystitis. 24 hours after the procedure, the patient felt abdominal distention and pain. An ultrasound and CT scan demonstrated abundant peritoneal free fluid. MRI with hepatic-specific contrast was performed, and it reported a biliary leak with liver specific contrast material pooling in the gallbladder fossa 20 minutes after injection. Biliary stent was placed by ERCP. Ultrasound-guided drainage with a pigtail was performed and the symptoms resolved.
Case co-author: Dr. Sven Kuestermann
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