Posttraumatic intrahepatic biloma: sonographic diagnosis.

Area of Science:

• Hepatobiliary imaging
• Diagnostic radiology
• Trauma surgery

Background:

• Posttraumatic intrahepatic biliary cysts (bilomas) were historically considered rare occurrences.
• Advancements in diagnostic imaging, particularly sonography and 99mTc-HIDA scintigraphy, have improved detection rates.
• This study focuses on the diagnostic approach to posttraumatic bilomas.

Observation:

• Five patients with posttraumatic bilomas were evaluated preoperatively.
• Key sonographic findings included well-circumscribed, anechoic hepatic lesions with significant distal sonic enhancement.
• These imaging characteristics are highly suggestive of biloma formation.

Findings:

• Sonography effectively identified the characteristic features of posttraumatic bilomas.
• Technetium-99m-labeled iminodiacetic acid (99mTc-HIDA) scintigraphy, especially with delayed imaging, confirmed the diagnosis.
• Percutaneous aspiration also served as a diagnostic tool.

Implications:

• Increased utilization of sonography and 99mTc-HIDA scintigraphy will likely lead to more frequent diagnoses of posttraumatic bilomas.
• Early and accurate diagnosis facilitates appropriate management of these injuries.
• Improved diagnostic strategies enhance patient outcomes following hepatic trauma.