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Spontaneous Pneumobilia: Not So Benign.
Abdul Ahad E Sheikh1, Khalid H Ahmed1, Sreekant Avula1
1Internal Medicine, The Wright Center for Graduate Medical Education, Scranton, USA.
Cureus
|May 19, 2021
Summary
Persistent pneumobilia, air in the biliary system, can be a benign finding. However, this case shows it can precede serious infections like Klebsiella cholangitis.
Area of Science:
- Gastroenterology and Hepatology
- Medical Imaging
- Infectious Diseases
Background:
- Pneumobilia, air in the biliary tree, typically results from abnormal gastrointestinal-biliary connections.
- Persistent asymptomatic pneumobilia is rare and often considered benign on imaging.
Observation:
- An 87-year-old male presented with long-standing, unexplained pneumobilia.
- The patient subsequently developed Klebsiella cholangitis and bacteremia.
Findings:
- This case highlights that persistent pneumobilia, even without an identifiable cause, may not always be benign.
- The study explores potential causes of spontaneous pneumobilia and its association with elevated intraabdominal pressure.
Implications:
- Clinicians should consider potential underlying risks in patients with persistent pneumobilia, even if asymptomatic.
- Further investigation into the relationship between pneumobilia, intraabdominal pressure, and infection is warranted.
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