A Nontraumatic Rupture of Intrahepatic Bile Duct and Perihepatic Biloma Formation in a Patient with Choledocholithiasis - A Case Report -

A Nontraumatic Rupture of Intrahepatic Bile Duct and Perihepatic Biloma Formation in a Patient with Choledocholithiasis - A Case Report -

Kyong-Hwa Jun, M.D., Hyun-min Cho, M.D., Hyung-min Chin, M.D., Jin-mo Yang, M.D.

, Seong-Su Hwang, M.D.

and Chung-Soo Chun, M.D.

Departments of Surgery,

Internal Medicine and

Radiology, College of Medicine, The Catholic University of Korea

A biloma is an extrahepatic or intrahepatic bile collection caused by traumatic, iatrogenic, or spontaneous rupture of the biliary tree. Prior reports have documented an association of a biloma with abdominal trauma and surgery, but spon- taneous bile leakage associated with other primary causes has rarely been reported. A 72-year-old man was admitted to our hospital with the complaint of epigastric pain and yellowish discoloration of the sclera. Ultrasonography and computed tomography revealed a large fluid collection in the abdominal cavity. Endoscopic retrograde cholangiography demonstrated leakage of contrast medium from a distended segmental biliary branch in the left lobe of the liver. A perihepatic biloma was confirmed by sonographically guided percutaneous aspiration, and the patient underwent a left lateral segmentectomy of the liver, a cholecystectomy and T-tube choledochostomy. Histological examination showed left lateral bile duct hyperplasia, with abscess formation and chronic cholecystitis. Herein, a case of a biloma associated with choledocholithiasis is reported, with a review of the literatures. (Korean J HBP Surg 2004;8:46-49)

Key Words: Biloma Spontaneous Choledocholithiasis

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