000			02688nam a22003977a 4500
008			200826s20202020 xxu||||| |||| 00| 0 eng d
022			_a2168-8184
024			_a10.7759/cureus.8116 [doi]
024			_aPMC7292700 [pmc]
040			_aOvid MEDLINE(R)
099			_a32542169
245			_aBiloma: A Rare Manifestation of Spontaneous Bile Leak.
251			_aCureus. 12(5):e8116, 2020 May 14.
252			_aCureus. 12(5):e8116, 2020 May 14.
253			_aCureus
260			_c2020
260			_fFY2020
265			_sepublish
266			_d2020-08-26
520			_aA 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.
546			_aEnglish
650			_aIN PROCESS -- NOT YET INDEXED
651			_aMedStar Franklin Square Medical Center
651			_aMedStar Good Samaritan Hospital
651			_aMedStar Union Memorial Hospital
656			_aInternal Medicine
657			_aCase Reports
700			_aChaudhary, Fizah
700			_aD'Souza, Rowena G
700			_aEhsan, Hamid
700			_aSittambalam, Charmian
700			_aYousaf, Muhammad N
790			_aChaudhary F, D'Souza RG, Ehsan H, Sittambalam C, Yousaf MN
856			_uhttps://dx.doi.org/10.7759/cureus.8116 _zhttps://dx.doi.org/10.7759/cureus.8116
942			_cART _dArticle
999			_c5349 _d5349