A rare case of hepatic subcapsular biloma after laparoscopic cholecystectomy and subsequent endoscopic retrograde cholangiopancreatography.

Abstract

Background: Biloma is a rare abnormal localized accumulation of bile out of biliary tree due to an injury that usually occurs postoperatively from an injured cystic or bile duct. While most bilomas collect in the subhepatic space, we describe a rare case of hepatic subcapsular biloma after laparoscopic cholecystectomy and endoscopic retrograde cholangiopancreatography (ERCP) which was successfully done one week after surgery treated by percutaneous drainage and placement of plastic stents in common bile duct (CBD). Case presentation: A 30-year-old woman with right upper quadrant pain referred to our center. Four weeks ago, she had a history of laparoscopic cholecystectomy and two weeks ago she had a history of ERCP. Abdominal ultrasonography showed a mass in her right liver lobe. The patient underwent the fluid aspiration under ultrasonography guidelines. Chemical analysis of aspirated fluid proved that the liquid was bile. A drainage catheter was placed in site of bile accumulation to drain the liquid. The next follow up ultrasonography showed that the mass disappeared and no recurrence was detected. Conclusions: Diagnosis of biloma in a patient with the history of laparoscopic cholecystectomy or ERCP should be considered for proper interventional treatment to reduce morbidity and mortality.