Computed tomographic demonstration of a bileoma.

Area of Science:

• Radiology
• Gastroenterology
• Surgical Pathology

Background:

• Extrahepatic bile collections can mimic other intra-abdominal pathologies.
• Accurate diagnosis is crucial for effective patient management and treatment.

Observation:

• A case presented with a large extrahepatic bile collection.
• Initial ultrasound examination was misinterpreted as normal.
• Computerized Tomography (CT) imaging was utilized for diagnosis.

Findings:

• The bile collection's appearance on CT was indistinguishable from a subcapsular hematoma or hepatic cyst.
• Percutaneous aspiration confirmed the diagnosis of an extrahepatic bile collection.
• The patient was successfully treated with percutaneous aspiration.

Implications:

• CT is a valuable tool for diagnosing complex abdominal collections.
• Missed diagnoses can occur with incomplete imaging reviews, emphasizing the need for thoroughness.
• Percutaneous aspiration offers a minimally invasive treatment option for extrahepatic bile collections.