Evaluation and treatment of intraabdominal bilomas

Vazquez, J L; Thorsen, M K; Dodds, W J; Quiroz, Francisco; Posadas‐Martinez, María Lourdes; Lawson, T L; Stewart, Edward T.; Foley, W D

doi:10.2214/ajr.144.5.933

Cited by 81 publications

(51 citation statements)

References 13 publications

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“…The differential diagnosis includes hematoma, seroma, liver abscess, pseudocyst, liver cyst, and lymphocele. Most bilomas have a CT number of less than 20 HU unless they are mixed with blood or exudates [8]. Biochemical and microbiological analysis of the fluid helps differentiation from pyogenic abscesses or other causes.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous biloma: Report of two cases with review of the literature

Goel¹,

Gupta²,

Bansal³

2017

Int J Surg Med

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Background Biloma is the collection of bile outside the biliary tree and can be intra or extrahepatic. It is most commonly iatrogenic, secondary to surgery or percutaneous transhepatic procedures or secondary to abdominal trauma. Spontaneous bilomas are very rarely described in the literature. Case reports Case 1: A 32-years-old female presented as lump abdomen in the epigastric region. Blood investigations were normal. Chest radiographs were unremarkable. Ultrasound examination revealed two cystic lesions about left lobe of liver and cholelithiasis with choledocholithiasis. Ultrasound-guided pigtail catheter drainage of the collection was done. ERCP failed to manage the choledocholithiasis. CBD exploration with choledocholithotomy and T-tube drainage and cholecystectomy was done. The postoperative period was uneventful, and the T-tube was removed on the 10th day after a normal T-tube cholangiogram. Case 2: A 32-year-old female admitted in an emergency with a complaint of acute pain in abdomen since two days. Ultrasound shows contracted gallbladder with stone along with focal collection in perihepatic and perigallbladder region extending into the subcutaneous plane with CBD stone. Ultrasound-guided pigtail catheter drainage of the collection was done. After five days she underwent ERCP by which CBD stones were cleared. Elective laparoscopic cholecystectomy was done. Conclusion A high index of clinical suspicion is necessary for prompt recognition and its proper management. Percutaneous treatment should be considered as the first-line option for patients with spontaneous biloma. In cases of persistent bile leaks, endoscopic biliary drainage and endoscopic sphincterotomy with or without stent placement should be performed. Surgery is now performed only in cases with a persistent bile leak or for treatment of an underlying disease.

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Section: Discussionmentioning

confidence: 99%

Spontaneous biloma: Report of two cases with review of the literature

Goel¹,

Gupta²,

Bansal³

2017

Int J Surg Med

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“…Small bilomas measuring only a few centimeters may be monitored, but the majority of bilomas require drainage. 33 Indications for treatment include large or increasing size, presence of biliary stricture or obstruction, presence of symptoms (jaundice, pain, fever, etc. ), or elevated white blood cell count or liver function tests.…”

Section: Discussionmentioning

confidence: 99%

“…Most bilomas are treated successfully with percutaneous or endoscopic drainage with surgery reserved for refractory or more complicated cases. 33,34 Drainage allows the bile duct leak to heal spontaneously with subsequent resolution of the biloma. Drain catheters are usually left in place until output ceases, 35 indicating the leak has resolved.…”

Section: Discussionmentioning

confidence: 99%

“…35,39,40 In rare instances, the bile leak persists and surgical repair may be necessary. 33 With appropriate treatment, the overall prognosis in the setting of biloma formation is excellent. 33 …”

Section: Discussionmentioning

confidence: 99%

“…33 With appropriate treatment, the overall prognosis in the setting of biloma formation is excellent. 33 …”

Section: Discussionmentioning

confidence: 99%

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Chemoembolization with Drug-Eluting Beads Complicated by Intrahepatic Biloma

Naumann¹,

Gupta²

2011

Semin intervent Radiol

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Chemoembolization with drug-eluting beads is a type of locoregional therapy currently being used for the treatment of hepatocellular carcinoma and metastatic disease to the liver. This treatment has proven effectiveness in controlling tumor growth, extending survival time, and improving quality of life. Chemoembolization with drug-eluting beads have been shown to be safe, but like any other invasive procedure, can have associated complications. The authors present a case of intrahepatic biloma formation occurring as a result of treatment with drug-eluting beads.

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