Spontaneous retroperitoneal bilious collection: A case report

Abstract

Biloma refers to the encapsulated accumulation of bile in the abdomen. Bilomas generally occur after bile duct disruption. The clinical case of the present report was a 75 Y/O woman with jaundice, fever, abdominal pain, lethargy, and anorexia who had been admitted to the emergency department. Endoscopic retrograde cholangiopancreatography (ERCP) showed severe diffuse dilation of the common bile duct (CBD) and common hepatic duct (CHD) with filling defects. One stone and some sludge and pus were extracted after balloon swiping. Plastic CBD stent placement was performed. An abdominal ultrasound scan showed a stone in the CBD and fluid collection in the right perirenal space. Under ultrasound guidance, a drainage tube was inserted into the retroperitoneal biloma. A serial ultrasound scan revealed a gradual decrease in the size of the biloma. Perforation of the bile duct, which is characterised by the collection of retroperitoneal fluid, is considered an extremely rare condition that can be fatal. Ultrasonography, computed tomography, and endoscopic retrograde cholangiopancreatography were used for the diagnosis. The treatment includes prevention of leakage and bile drainage.