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VOLUME 56 , ISSUE 2 ( April-June, 2022 ) > List of Articles

CASE REPORT

Impending Rupture of Lesser Sac Biloma into the Stomach

Surinder S Rana, Rajesh Gupta, Suhang Verma, Ravi Sharma

Keywords : Biloma, Cholecystectomy, Endoscopy, Endosonography, Stents

Citation Information : Rana SS, Gupta R, Verma S, Sharma R. Impending Rupture of Lesser Sac Biloma into the Stomach. J Postgrad Med Edu Res 2022; 56 (2):91-93.

DOI: 10.5005/jp-journals-10028-1431

License: CC BY-NC 4.0

Published Online: 07-06-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Biliary injury with bile leak is a well-recognized complication following cholecystectomy. This results in an accumulation of bile within the peritoneal cavity and may manifest with biliary ascites and peritonitis or as a localized collection called biloma. Bilomas are usually intrahepatic or are located in a subhepatic or subphrenic location with the less sac being a rare location for biloma. We present a rare case of a large biloma located in the less sac compressing the stomach. The patient was successfully managed endoscopically by the placement of multiple transmural plastic stents after cannulating and dilating the transmural tract of its impending rupture into the stomach.


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  1. Sharda S, Sharma A, Khullar R, et al. Post-laparoscopic cholecystectomy biloma in the lesser sac: a rare clinical presentation. J Minim Access Surg 2015;11(2):154–156. DOI: 10.4103/0972-9941.140215
  2. Sisler WJ. Massive biloma in lesser sac of peritoneal cavity after cholecystectomy. AJR Am J Roentgenol 1993;160(4):899–900. DOI: 10.2214/ajr.160.4.8456696
  3. Baron TH. Combined endoscopic transgastric and transpapillary drainage of an infected biloma. Endoscopy 2006;38(4):436. DOI: 10.1055/s-2006-925174
  4. Thurley PD, Dhingsa R. Laparoscopic cholecystectomy: postoperative imaging. Am J Roentgenol 2008;191(3):794–801. DOI: 10.2214/AJR.07.3485
  5. Kaffes AJ, Hourigan L, De Luca N, et al. Impact of endoscopic intervention in 100 patients with suspected postcholecystectomy bile leak. Gastrointest Endosc 2005;61(2):269–275. DOI: 10.1016/S0016-5107(04)02468-X
  6. Lee CM, Stewart L, Way LW. Postcholecystectomy abdominal bile collections. Arch Surg 2000;135(5):538–544. DOI: 10.1001/archsurg.135.5.538
  7. Copelan A, Bahoura L, Tardy F, et al. Etiology, diagnosis, and management of bilomas: a current update. Tech Vasc Interv Radiol 2015;18(4):236–243. DOI: 10.1053/j.tvir.2015.07.007
  8. Mueller P, Ferrucci J, Simeone J, et al. Detection and drainage of bilomas: special considerations. Am J Roentgenol 1983;140(4):715–720. DOI: 10.2214/ajr.140.4.715
  9. Melamud K, LeBedis CA, Anderson SW, et al. Biliary imaging: multimodality approach to imaging of biliary injuries and their complications. Radiographics 2014;34(3):613–623. DOI: 10.1148/rg.343130011
  10. Ponnudurai R, George A, Sachithanandan S, et al. Endoscopic ultrasound-guided drainage of a biloma: a novel approach. Endoscopy 2006;38(2):199. DOI: 10.1055/s-2006-
  11. Shami VM, Talreja JP, Mahajan A, et al. EUS-guided drainage of bilomas: a new alternative? Gastrointest Endosc 2008;67(1):136–140. DOI: 10.1016/j.gie.2007.07.040
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