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

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.