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[Intrahepatic biloma. Conservative management with external drainage]
X García Urguellés1, J Uroz Tristán, R Avila Suarez
1Servicio de Cirugía Pediátrica, Hospital Materno-Infantil, Las Palmas de Gran Canaria.
Summary
Intrahepatic biliomas, a rare complication of liver trauma, can be successfully treated with external drainage. This conservative approach, guided by ultrasound, resolved a bilioma and biliary fistula in a pediatric patient.
Area of Science:
- Hepatobiliary surgery
- Pediatric surgery
- Medical imaging
Background:
- Blunt liver trauma can lead to rare complications such as intrahepatic biliomas.
- Surgical intervention for trauma may predispose patients to post-traumatic biliary collections.
- Early diagnosis and management are crucial for favorable outcomes in pediatric liver injuries.
Observation:
- A seven-year-old boy developed an intrahepatic bilioma one week after surgery for blunt liver trauma.
- Ultrasonography revealed the intrahepatic collection, and external drainage was performed under guidance.
- Contrast injection confirmed a biliary fistula, indicating leakage of bile.
Findings:
- External drainage facilitated the resolution of the intrahepatic bilioma.
- Follow-up contrast injections demonstrated the closure of the biliary fistula.
- Both ultrasonography and CT scans confirmed the complete resolution of the intrahepatic collection.
Implications:
- Conservative management, including external drainage, is a viable first-line therapeutic option for intrahepatic biliomas.
- Minimally invasive techniques like ultrasound-guided drainage can effectively manage post-traumatic biliary collections.
- This case highlights the importance of considering conservative management in rare complications of hepatic trauma.