Biloma Presentation after Six Months of Thoracoabdominal Trauma: A Case Report

Abstract

Perforation of biliary tree will result in accumulation of bile as a collection called biloma. Post-traumatic biloma is diagnosed mostly soon after the trauma happened. We are reporting about a patient with traumatic biloma whose manifestation of symptoms appeared six months after an abdominal blunt trauma. A 65-year-old male reported with the complaint of nausea and abdominal pain since three days. On examination, a rigid abdominal mass was detected in the right upper quadrant, which was increasing in size. The patient had a record of admission in his medical history due to blunt thoracoabdominal trauma, six months ago. On laboratory investigations, there was a rise in the level of alkaline phosphatase. Computed Tomography scanning showed a fluid collection with pressure effect on liver. Emergency operation was performed for drainage and about 2 L of bile was discharged via percutaneous drainage. CT scan performed immediately after operation showed liver in the normal site and decompressed. Following-up, the patient was asymptomatic for one year. Traumatic biloma is a probable diagnosis in patients with abdominal trauma even if there is a long period of time between the incidence of trauma and the appearance of symptoms. Biloma is managed mostly by surgical methods in order to drain and find the leakage but in some cases even a percutaneous drainage can be effective.

Keywords

• abdominal injuries
• abdominal pain
• biliary tract