Presentation
Post cholecystectomy follow-up
Patient Data
There is large subcapsular collection in the right lobe of the liver extending into the expected gallbladder fossa and adjacent subcutaneous tissue. It measures approximately 35x14 cm.
It compresses adjacent liver parenchyma, right kidney, and pancreatic head towards the left.
It also compresses the right hemidiaphragm resulting collapse of the posterior segment of the right lower lobe.
Ring artifact is seen.
Distended gallbladder with mild enhancing wall thickening containing hyperdense calculus in the gall bladder fossa suggests calculus cholecystitis.
Case Discussion
Post-cholecystectomy biloma is a fluid collection of bile after surgical removal of the gallbladder.
On CT scan radiographic features include water density fluid accumulation nearby to the biliary system, most frequently in the gallbladder fossa, subphrenic, and Morison pouch.
CT intravenous cholangiography can display communication between the biliary tree and the biloma, localizing the leak.
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