TY  - BOOK
AU  - Chaudhary, Fizah
AU  - D'Souza, Rowena G
AU  - Ehsan, Hamid
AU  - Sittambalam, Charmian
AU  - Yousaf, Muhammad N
TI  - Biloma: A Rare Manifestation of Spontaneous Bile Leak
SN  - 2168-8184
PY  - 2020///
KW  - IN PROCESS -- NOT YET INDEXED
KW  - MedStar Franklin Square Medical Center
KW  - MedStar Good Samaritan Hospital
KW  - MedStar Union Memorial Hospital
KW  - Internal Medicine
KW  - Case Reports
N2  - A biloma is an intrahepatic or extrahepatic encapsulated collection of bile outside of the biliary tree and within the abdominal cavity. Hepatobiliary  interventions and laparoscopic cholecystectomy are the most common etiologies of biloma followed by abdominal trauma, choledocholithiasis, and biliary  dilation secondary to biliary stricture. We report a case of a 91-year-old female who presented to the emergency room with an acute onset of epigastric and  right upper quadrant sharp pain for one day that radiated to the back, and was associated with two to three episodes of vomiting. Initial abdominal imaging  including CT scan, ultrasound and magnetic resonance cholangiopancreatography (MRCP) of the abdomen and pelvis revealed a distended gallbladder with wall  thickening, but without evidence of pancreatitis or gallstones. Hepatobiliary iminodiacetic acid (HIDA) scan findings were consistent with extrahepatic  biliary leakage into the peritoneum. A cholangiogram demonstrated a perihepatic biloma. A combined approach using fluoroscopic-guided biloma drainage and  endoscopic retrograde cholangiopancreatography (ERCP)-guided biliary stent placement across the site of the biliary leak resulted in the complete resolution  of symptoms. Biloma should be included in the differential diagnosis of right upper quadrant abdominal pain. A high index of clinical suspicion is required  for early diagnosis and treatment. Copyright (c) 2020, Yousaf et al
UR  - https://dx.doi.org/10.7759/cureus.8116
ER  -