SUCCESSFUL MANAGEMENT WITH PERCUTANEOUS DRAINAGE OF A SPONTANEOUS BILOMA ACCOMPANIED WITH INCARCERATED BILE DUCT STONE -A CASE REPORT-

Abstract

We experienced a case of Biloma which was formed by bile juice leakage into the subcapsular space of the liver due to incarcerated bile duct stone. An 80-year-old woman was admitted to the hospital because of fever and right hipochondralgia. Abdominal CT-scan and ultrasonography on admission demonstrated a stone, 1cm in diameter, in the dilated common bile duct and a giant cystic lesion in the subcapsular space of the right hepatic lobe. Under ultrasonographic guidance, the cystic lesion was percutaneously drained. The aspirated fluid revealed bile and she was diangosed as having a biloma accopanied with bile duct stone. The continuous drainage of the biloma brought about disappearance of cystic lesion 19 days after admission and the bile stone had pased through the papilla Vater. Bilomas are predominantly reported to develop traumatically or iatrogenically. In the Japanese literature, 21 cases of spontaneously developed biloma have been reported which were associated with hepatobiliary diseases. Fifteen of 21 cases had bile duct stones. In suspected patients of biloma, percutaneous drainage should be done to make the definitive diagnosis and to relief the symptoms by indwelling a catheter for continuous drainage.