A 42-year-old female presented with abdominal distension and pain following a laparoscopic cholecystectomy. She underwent re-exploratory laparotomy where 4 liters of bile was drained. On examination, she had jaundice and abdominal tenderness. Imaging showed a 1.8 liter fluid collection in the lesser sac. The doctor's plan is for pigtail catheterization and possible ERCP and stenting thereafter to manage suspected CBD injury following her previous surgery.

1. Suspected CBD Injury

2. HISTORY
• Patient Ghulam Sakina, 42 Y/F underwent Lap Chole from Kharian on
12-05-22 following which patient developed abdominal distension &
pain
• Re-exp laparotomy was done from Aziz Fatima Hospital and drain was
placed (approx. 4L bile drained)
• Patient was referred to Shaikh Zayed for further management.

3. EXAMINATION
• O/E Jaundice +ve
• Abdomen tender with dullness in epigastric and umbilical region

4. Investigations
• TLC = 11.6
• Hb = 9.4
• PLT =422
• Bilirubin = 10.4 (Now 1.2)
• K = 3.8
• Na = 133
• Lipase = 62
• Gamma GT = 76
• Amylase 74

5. • USG Abdomen: 1.8 L fluid collection in lesser sac. Rest is
unremarkable

6. Patient D/W Dr. Amir Khan
• Pig tail catheterization
• Possible plan for ERCP & stenting after that