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Spontaneous retroperitoneal bilious collection: A case report
Golnaz Moradi1, Mohaddeseh Rezaei2, Seyed A Miratashi Yazdi3
1Department of Radiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Journal of Taibah University Medical Sciences
|August 19, 2022
Summary
A rare case of bile duct perforation presented as a retroperitoneal biloma in a 75-year-old woman. Prompt diagnosis and drainage of the biloma were crucial for successful treatment.
Area of Science:
- Gastroenterology
- Abdominal Surgery
Background:
- Bilomas are encapsulated bile collections typically resulting from bile duct disruption.
- Bile duct perforation is an extremely rare and potentially fatal condition.
Observation:
- A 75-year-old female presented with jaundice, fever, abdominal pain, lethargy, and anorexia.
- Endoscopic retrograde cholangiopancreatography revealed severe dilation of the common bile duct (CBD) and common hepatic duct (CHD) with filling defects, including a stone, sludge, and pus.
- Abdominal ultrasound identified a CBD stone and a fluid collection in the right perirenal space, indicative of a retroperitoneal biloma.
Findings:
- Diagnosis was established using ultrasonography, computed tomography, and ERCP.
- Treatment involved endoscopic retrograde cholangiopancreatography with plastic CBD stent placement and ultrasound-guided drainage of the retroperitoneal biloma.
- Serial ultrasound scans demonstrated a progressive decrease in biloma size following drainage.
Implications:
- This case highlights the importance of prompt diagnosis and management of rare bile duct perforations presenting as bilomas.
- Effective treatment strategies involve preventing further bile leakage and ensuring adequate bile drainage.
- Early intervention can prevent severe complications and improve patient outcomes in cases of bile duct perforation.
