Bilio-thorax: an unrecognized complication of liver surgery

INTRODUCTION: Although a rare complication, Biliothorax, or thole-thorax as it has been called in literature, is a devastating entity if not recognized early. Various causes have been reported for biliothorax like inflammatory, abdominal trauma, neoplastic, the most frequent being percutaneous hepatic intervention. CASE: We present the case of a 60 year old male, treated for colon cancer, who developed this complication after liver surgery. He was promptly diagnosed, managed conservatively and responded to our treatment. This has been infrequently reported. DISCUSSION: Although a rare complication, Biliothorax, is a fatal complication if missed. The presence of bile in the pleural cavity is damaging and can lead to empyema, entrapped lung and even ARDS. Hence it is imperative to recognize early, find the cause and treat appropriately. CONCLUSION: Biliothorax is an under reported complication of liver surgery which can have disastrous effects on the patient leading to morbidity and even mortality. It is vital to recognize it early and treat accordingly. (C) 2020 The Author(s). Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.