Laparoscopic management of bile peritonitis after liver biopsy.

Bile peritonitis is an infrequent complication of liver biopsy and is usually treated by supportive care or laparotomy. Fever, peritoneal signs, and hemoconcentration developed in a 56-year-old man 7 hr after biopsy. At laparoscopy, a large amount of cloudy, bilious fluid was aspirated using a suction-irrigation device. No liver injury or bile leak was seen. The patient gradually improved and, although he required percutaneous drainage of the subhepatic bile collection, did well. This case illustrates the new use of laparoscopy to manage bile peritonitis after liver biopsy. Compared with conventional laparotomy, this procedure has the advantages of lower intraoperative risk, shorter recovery time, and superior visualization of peritoneal contents.

Planning an airport disaster drill.

The authors have prepared this paper to serve as a guide for planning airport disaster drills, particularly at the major air carrier airports. Their recommendations are subject to change according to the needs of the individual airport and the particular circumstances that may be present. Basically, the recommendations are founded on the experience gained by participation in planning and carrying out five separate emergency or disaster drills (Oakland International Airport 1, San Francisco International Airport 2, Los Angeles International Airport 2). The authors also have been involved in a total of three additional disaster drills in California and have been involved in one way or another in an additional 19 airport disaster drills throughout the United States. The presentation is divided into segments according to activity. However, it should be noted that there is a cohesiveness necessary for disaster planning if the drill is to be successful.