PMID- 32542169
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200928
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 12
IP  - 5
DP  - 2020 May 14
TI  - Biloma: A Rare Manifestation of Spontaneous Bile Leak.
PG  - e8116
LID - 10.7759/cureus.8116 [doi]
LID - e8116
AB  - 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.
CI  - Copyright (c) 2020, Yousaf et al.
FAU - Yousaf, Muhammad N
AU  - Yousaf MN
AD  - Internal Medicine, MedStar Union Memorial Hospital, Baltimore, USA.
AD  - Internal Medicine, MedStar Franklin Square Medical Center, Baltimore, USA.
AD  - Internal Medicine, MedStar Good Samaritan Hospital, Baltimore, USA.
AD  - Section of Digestive Diseases, Yale University School of Medicine, New Haven, 
      USA.
FAU - D'Souza, Rowena G
AU  - D'Souza RG
AD  - Medicine, MedStar Union Memorial Hospital, Baltimore, USA.
FAU - Chaudhary, Fizah
AU  - Chaudhary F
AD  - Internal Medicine, MedStar Union Memorial Hospital, Baltimore, USA.
FAU - Ehsan, Hamid
AU  - Ehsan H
AD  - Internal Medicine, MedStar Union Memorial Hospital, Baltimore, USA.
FAU - Sittambalam, Charmian
AU  - Sittambalam C
AD  - Geriatrics, MedStar Franklin Square Medical Center, Baltimore, USA.
LA  - eng
PT  - Case Reports
DEP - 20200514
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC7292700
OTO - NOTNLM
OT  - : biloma
OT  - ercp
OT  - hepatobiliary interventions
OT  - pancreatitis
OT  - percutaneous drainage
OT  - spontaneous bile leak
COIS- The authors have declared that no competing interests exist.
EDAT- 2020/06/17 06:00
MHDA- 2020/06/17 06:01
PMCR- 2020/05/14
CRDT- 2020/06/17 06:00
PHST- 2020/06/17 06:00 [entrez]
PHST- 2020/06/17 06:00 [pubmed]
PHST- 2020/06/17 06:01 [medline]
PHST- 2020/05/14 00:00 [pmc-release]
AID - 10.7759/cureus.8116 [doi]
PST - epublish
SO  - Cureus. 2020 May 14;12(5):e8116. doi: 10.7759/cureus.8116.