Pneumobilia: a comparison of four imaging modalities

Area of Science:

• Radiology
• Gastroenterology
• Medical Imaging

Background:

• Biliary-enteric anastomoses are common surgical procedures.
• Patients often undergo surveillance for liver metastases.
• Pneumobilia is a frequent finding in this patient population.

Purpose of the Study:

• To review imaging findings of pneumobilia in patients with biliary-enteric anastomoses.
• To differentiate pneumobilia from metastatic liver disease on imaging.
• To assess the accuracy of different imaging modalities.

Main Methods:

• Retrospective review of 25 patients with biliary-enteric anastomoses.
• Analysis of computed tomography (CT), ultrasound, radionuclide scans, and plain abdominal radiographs.
• Correlation of imaging findings with clinical data.

Main Results:

• The majority of patients demonstrated pneumobilia.
• Typical imaging features of pneumobilia were identified across modalities.
• No discrepancies were found between radionuclide, CT, and ultrasound for liver metastases diagnosis.

Conclusions:

• Pneumobilia is a common and expected finding after biliary-enteric anastomosis.
• Radiologists must be aware of pneumobilia to avoid misinterpreting it as metastatic disease.
• CT, ultrasound, and radionuclide scans are reliable for diagnosing liver metastases in these patients.