An unusual presentation of biloma five years following cholecystectomy: a case report

Abstract

A 34-year-old female presented with right hypochondrial pain of 6 months following an uneventful open cholecystectomy about 5 years ago. A firm intra abdominal lump was felt in the right hypochondrium. Ultrasonography and computed tomography of the abdomen showed a large cystic lesion in relation to the porta hepatis. On exploration, a large cystic mass was found in relation to the undersurface of liver, adherent to the colon and duodenum. The cyst was excised leaving a cuff of cyst wall, densely adherent to the duodenum. A small opening with bile trickling through it was noted in the region of the confluence of hepatic ducts. Choledochotomy was done and T-tube placed. The bilious output from the sub-hepatic drain gradually decreased and the repeat T-tube cholangiogram on 14th day following surgery was normal. The patient, at one year of follow-up is asymptomatic with normal liver function tests.

Figure 1

Computed tomography of the abdomen showing a large cystic lesion (C) abutting the Liver (L) and the Duodenum (D).

Figure 2

T-Tube cholangiogram done on post operative day 14 shows normal biliary tract with patent bilio-enteric pathway. Cholecystectomy was done about 5 years ago.