Demarcated Truncal Jaundice: A Sign of Retroperitoneal Bile Leakage
Authors: Vivian C. McAlister, Alp Sener
Journal: Annals of Internal Medicine (2005)

Letters1 March 2005Demarcated Truncal Jaundice: A Sign of Retroperitoneal Bile LeakageVivian C. McAlister, MB and Alp Sener, MDVivian C. McAlister, MBFrom University of Western Ontario, London, Ontario N6A 5A5, Canada.Search for more papers by this author and Alp Sener, MDFrom University of Western Ontario, London, Ontario N6A 5A5, Canada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-142-5-200503010-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Background: The usual treatment for abdominal collection of bile is percutaneous drainage followed by endobiliary stenting for persistent leaks (1). Delayed drainage can have severe consequences (1). Retroperitoneal bile leaks may behave differently and require different care.Case Reports: A 43-year-old man was referred with abdominal pain and jaundice 4 days after cholecystectomy. The surgeon had difficulty dissecting the cystic duct, which retracted into the peritoneal fold when it was clipped and divided. A tube placed at the surgical site drained small quantities of serous fluid, but not bile. Skin discoloration was limited to the flanks and ...References1. Lee CM, Stewart L, Way LW. Postcholecystectomy abdominal bile collections. Arch Surg. 2000;135:538-42. [PMID: 10807277] CrossrefMedlineGoogle Scholar2. Colovic R, Perisic-Savic M. Retroperitoneal biloma secondary to operative common bile duct injury. HPB Surg. 1991;3:193-7. [PMID: 2043516] CrossrefMedlineGoogle Scholar3. Neoptolemos JP, Harvey MH, Slater ND, Carr-Locke DL. Abdominal wall bile staining and ‘biliscrotum’ after retroperitoneal perforation following endoscopic sphincterotomy. Br J Surg. 1984;71:684. [PMID: 6236865] CrossrefMedlineGoogle Scholar4. George Henry Fox. Whonamedit.com. Accessed at www.whonamedit.com/doctor.cfm/1468.html on 10 December 2004. Google Scholar5. Cullen TS. A new sign in ruptured extra-uterine pregnancy. American Journal of Obstetric Disorders in Women and Children. 1918;78:457. Google Scholar6. Grey Turner G. Local discoloration of the abdominal wall as a sign of acute pancreatitis. Br J Surg. 1920;7:394-5. CrossrefGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Western Ontario, London, Ontario N6A 5A5, Canada. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoScholarship Erosion John G. Sotos Scholarship Erosion Robert G. Badgett , Michael Berkwits , and Cynthia Mulrow Metrics Cited ByRetroperitoneal bile leak after laparoscopic cholecystectomyAbdominal Wall Bile Staining Without JaundiceScarpa’s fascia and clinical signs: the role of the membranous superficial fascia in the eponymous clinical signs of retroperitoneal catastropheScholarship ErosionJohn G. Sotos, MD 1 March 2005Volume 142, Issue 5Page: 389KeywordsBileBilirubinEdemaHemorrhageLaparoscopic cholecystectomyLigamentsPancreatitisStainingThoraxUrine ePublished: 1 March 2005 Issue Published: 1 March 2005 CopyrightCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...