A Case of Spontaneous Biloma with Cholecystitis

Yasunori Kato, Yoshinori Hamada, Takashi Mouri, Koshiro Hioki

Second Department of Surgery, Kansai Medical University

53-year-old woman was admitted with fever and epigastralgia. An abdominal enhanced CT scan and ultrasound examination revealed enlargement of the gallbladder and a cystic lesion below the left lobe of the liver, indicating probable cholecystitis and a biloma. Cholecystectomy with resection of the cyst was performed. The cyst contained turquoise-colored fibrin. Our case was classified as one of spontaneous biloma that had no evidence of trauma or iatrogenic injury. Twenty-two other cases of spontaneous biloma were previously reported in Japan. In our case, the biloma was thought to have been due to biliary leakage from the gallbladder with severe cholecystitis, in which obstruction of the cystic duct with infective hydrops had progressed. Thus, in case of severe cholecystitis with an intraabdominal cystic lesion, the presence of spontaneous biloma should be suspected in the differential diagnosis.

Key words
spontaneous biloma, cholecystitis, spiral-computed tomography

Reprint requests
Yasunori Kato Second Department of Surgery, Kansai Medical University
10-15 Fumizono, Moriguchi, 570-8507 JAPAN

Accepted
April 22, 1998

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