Bile peritoneum as an underestimated complication after open right adrenalectomy: Case report

Vidangos-Paredes G.; Rijalba-Monsefú V.; Vela-Ruiz J.M. · Revista de Cirugia (2026) · DOI: 10.35687/s2452-454920260043051

Resumen

Objective: To describe a case of bile peritoneum secondary to liver laceration as a rare and underestimated complication following open right adrenalectomy. Case report: A 68-year-old man diagnosed with right adrenocortical carcinoma, initially asymptomatic, presented with progressive tumor growth and secretory characteristics. He underwent open right adrenalectomy without apparent intraoperative complications. Twenty-four hours postoperatively, he developed diffuse abdominal pain, signs of peritoneal irritation, and biliary drainage. Computed tomography revealed perihepatic free fluid, prompting an urgent exploratory laparotomy. A liver laceration in segments IV and V was identified, without injury to the common biliary tree. Peritoneal lavage and drainage were performed, with a favorable clinical outcome. Discussion: Bile peritoneum secondary to liver laceration is an extremely rare complication following right adrenalectomy, generally related to retraction and dissection maneuvers in large tumors. Early recognition and timely surgical reintervention were crucial to avoid septic complications and achieve a favorable outcome.