Published online May 28, 2013. doi: 10.4329/wjr.v5.i5.220
Revised: April 11, 2013
Accepted: May 16, 2013
Published online: May 28, 2013
Processing time: 86 Days and 24 Hours
A biloma is a rare disease characterized by an abnormal intra- or extrahepatic bile collection due to a traumatic or spontaneous rupture of the biliary system. Laboratory findings are nonspecific. The diagnosis is usually suspected on the basis of a typical history (right upper quadrant abdominal pain, chills, fever and recent abdominal trauma or surgery) and is confirmed by detection of typical radiologic features. We report the case of a patient with a history of previous cholecystectomy for lithiasis who presented with clinical symptoms and laboratory data suggestive of acute pancreatitis. Imaging studies also revealed the presence of a chronic and asymptomatic biloma, which could be mistaken for a pseudocyst. The atypical location and ultrasound findings suggested an alternative diagnosis. We therefore reviewed the known literature for bilomas, focusing on the role of ultrasonography, which can reveal some typical aspects, such as location and imaging features. We conclude that ultrasound plays a key role in the assessment of a suspected biloma in patients with appropriate history and clinical features and provides valuable diagnostic clues even in the absence of these.
Core tip: We report the case of a patient with a history of previous cholecystectomy for lithiasis who presented with a clinical picture suggestive of acute pancreatitis. Imaging studies revealed the presence of an asymptomatic biloma, which could be mistaken for a pseudocyst. We therefore reviewed the literature, focusing on the role of ultrasonography, which can reveal some typical aspects, such as location and imaging features. We conclude that ultrasound plays a key role in the assessment of a suspected biloma in patients with appropriate history and clinical features and provides valuable diagnostic clues even in the absence of these.