Empiema pleural secundario a cálculo biliar. Una complicación infrecuente / Pleural empyema secondary to gallstone. An infrequent complication

RESUMEN

Mujer de 84 años que acude a Urgencias por presentar en la semana previa dolor en costado derecho de características pleuríticas asociado a fiebre tras haberse sometido a colecistectomía dos semanas antes. En la radiografía de tórax presenta derrame pleural, confirmándose en la tomografía computarizada de tórax con contraste y objetivándose derrame pleural loculado, así como una imagen compatible con litiasis biliar. Posteriormente se realiza toracocentesis diagnóstica en la que se obtienen resultados compatible con empiema. Se coloca drenaje pleural con instilación de uroquinasa y antibioterapia empírica, presentando buena evolución. Se establece el diagnóstico de empiema pleural secundario a cálculo biliar intraperitoneal (AU)

ABSTRACT

An 84-year-old woman come to the emergency department for presenting in the previous week pleuritic right flank pain associated with fever after having undergone cholecystectomy 2 weeks earlier. She presents pleural effusion in the chest X-ray, which was confirmed in the chest computered tomography with contrast, showing loculated pleural effusion, as well as an image compatible with biliary lithiasis. Subsequently, diagnostic thoracentesis is performed and the results were compatible with empyema. Pleural drainage is placed with urokinase instillation and empirical antibiotherapy, presenting good evolution. The diagnosis of pleural empyema secondary to intraperitoneal gallstone is established (AU)