Unusual Presentation of Left-Sided Bilothorax Following Spleen Laceration: A Case Without Biliary Tree Injury.
- 1Pulmonary Medicine Asian Institute of Gastroenterology Hyderabad India.
Abstract
A 46-year-old pedestrian sustained blunt injury to abdomen when he was struck from behind by a motorcycle, causing him to fall flat onto the roadway. Ultrasound abdomen showed splenic injury and hemoperitoneum. Chest x-ray showed left mild pleural effusion. He was managed conservatively by multiple blood transfusions for anemia and referred to our center after 3 weeks. A triphasic CT scan of abdomen revealed a splenic laceration with multiple pseudoaneurysms, moderate hemoperitoneum, and trace bilateral pleural effusions. No biliary tree injury or fistula was identified. On fifth postoperative day after splenectomy, he developed progressive breathlessness and ultrasound showed increased effusion on left side. Around 500 mL of green pleural fluid was aspirated, which was exudative by Light's criteria and cultures were sterile. Pleural fluid to serum bilirubin ratio was more than one, confirming diagnosis of bilothorax. The most likely mechanism for development of bilothorax is due to resorption of hemoperitoneum and splenic hematoma across left diaphragm into pleural space and heme degradation.
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BibTeX
@article{reddipilli2026unusual,
title = {{Unusual Presentation of Left-Sided Bilothorax Following Spleen Laceration: A Case Without Biliary Tree Injury.}},
author = {Thanuja Reddipilli and Raghava Rao Gandra and Vishwanath Gella and Deekshitha Ithepalli},
journal = {Clinical case reports},
year = {2026},
month = nov,
doi = {10.1002/ccr3.73841},
url = {https://europepmc.org/article/MED/42999557},
note = {CC BY},
}
RIS
TY - JOUR
TI - Unusual Presentation of Left-Sided Bilothorax Following Spleen Laceration: A Case Without Biliary Tree Injury.
AU - Thanuja Reddipilli
AU - Raghava Rao Gandra
AU - Vishwanath Gella
AU - Deekshitha Ithepalli
PY - 2026
DA - 2026/11/07
JO - Clinical case reports
DO - 10.1002/ccr3.73841
UR - https://europepmc.org/article/MED/42999557
AB - A 46-year-old pedestrian sustained blunt injury to abdomen when he was struck from behind by a motorcycle, causing him to fall flat onto the roadway. Ultrasound abdomen showed splenic injury and hemoperitoneum. Chest x-ray showed left mild pleural effusion. He was managed conservatively by multiple blood transfusions for anemia and referred to our center after 3 weeks. A triphasic CT scan of abdomen revealed a splenic laceration with multiple pseudoaneurysms, moderate hemoperitoneum, and trace bilateral pleural effusions. No biliary tree injury or fistula was identified. On fifth postoperative day after splenectomy, he developed progressive breathlessness and ultrasound showed increased effusion on left side. Around 500 mL of green pleural fluid was aspirated, which was exudative by Light's criteria and cultures were sterile. Pleural fluid to serum bilirubin ratio was more than one, confirming diagnosis of bilothorax. The most likely mechanism for development of bilothorax is due to resorption of hemoperitoneum and splenic hematoma across left diaphragm into pleural space and heme degradation.
SN - 2050-0904
ER -