# Diagnosis and Operative Management of a Cholecystopleural Fistula Following Iatrogenic Injury

## TL;DR

This paper discusses the diagnosis and surgical treatment of a rare abnormal connection between the gallbladder and pleural space caused by medical procedures.

## Contribution

The paper presents a unique case of iatrogenic cholecystopleural fistula and its successful surgical management.

## Key findings

- The patient developed a cholecystopleural fistula after a failed percutaneous cholecystostomy.
- Surgical intervention with cholecystectomy and thoracic surgery resolved the complications.
- Early recognition of such fistulas is critical to prevent serious complications.

## Abstract

A cholecystopleural fistula is an abnormal connection between the gallbladder and the pleural space. Potential causes of this rare fistula include malignancy, trauma, iatrogenic injury, and more. Failure to recognize a cholecystopleural fistula can lead to various serious complications. We present the case of a patient who underwent an aborted percutaneous cholecystostomy tube placement for recurrent acute cholecystitis, followed by percutaneous transhepatic biliary tube placement with a clinical course that was complicated by the development of an empyema. The patient was managed operatively with a cholecystectomy and a video-assisted thoracic surgery with total lung decortication, followed by cholecystopleural fistula takedown and diaphragm repair. This case demonstrates the importance of recognizing these rare fistulas and highlights specific considerations regarding thoracic-related complications.