Abstract:
Biloma is an intrahepatic or extrahepatic collection of bile within the abdominal cavity. It can occur spontaneously, or as a result of trauma to the biliary tree. The clinical presentation can be variable and non-specific. Early diagnosis is crucial given the high mortality rate. Diagnostic modalities include abdominal ultrasound, hepatobiliary scintigraphy, computerized tomography (CT), and magnetic resonance imaging (MRI). Treatment options include interventional radiology (IR)-guided drainage, endoscopic drainage, or surgical drainage with a bile leak repair. We report a case of a middle-aged non-cirrhotic patient who presented with abdominal pain and was noted to have extensive portal vein thrombosis. She underwent transjugular intrahepatic portosystemic shunt (TIPS) with thrombectomy and the hospital course was complicated by elevated liver enzymes and found to have intrahepatic biloma requiring IR-guided drainage.
摘要:
Biloma是腹腔内胆汁的肝内或肝外集合。它可以自发发生,或者是胆道损伤的结果.临床表现可以是可变的和非特异性的。考虑到高死亡率,早期诊断至关重要。诊断方式包括腹部超声,肝胆闪烁显像,计算机断层扫描(CT),磁共振成像(MRI)。治疗方案包括介入放射学(IR)引导引流,内镜引流,或手术引流与胆漏修复。我们报告了一例中年非肝硬化患者,该患者表现为腹痛,并被发现有广泛的门静脉血栓形成。她接受了经颈静脉肝内门体分流术(TIPS)并进行了血栓切除术,住院过程因肝酶升高而复杂化,发现肝内胆汁瘤需要IR引导引流。