A Case of Biloma due to Cholecystitis Showing Unusual Feature of Imaging

Kenichi Sakamoto, Hajime Hirose, Takuya Yamada, Mikio Yasumura, Miki Mori, Tsuyoshi Shimamoto, Toyoo Nitta, Naoki Futamura and Kuniyasu Shimokawa^*

First Department of Surgery, Gifu University School of Medicine
^*Clinical Laboratory, Gifu University School of Medicine

We report the case of biloma due to cholecystitis showing unusual feature of imaging. The patient was a 64-year-old man. Two months ago he had right hypochondralgia and fever, and was diagnosed to have acalculous cholecystitis. Although the condition was improved by conservative treatment, the patient visited our hospital for the purpose of identification of the precise etiology. A cystic lesion of 4.5×2.0cm in size, which was adjacent to the neck of gallbladder and showed a clear border with the liver, was observed. Abdominal US revealed a structure of 1.4 cm in diameter with strong peripheral echo and no internal echo in the cystic lesion. Cholangiography showed compression of the cystic duct and a lightly contrasted area from the cystic duct to the cranial side of the neck of gallbladder. Double gallbladder or biloma due to cholecystitis was suspected, so conventional cholecystectomy was performed with excision of the cystic lesion. A cystic mass containing black-brown serous content was observed over the area from the cystic duct to the ventral side of the neck of gallbladder. The wall of the cyst did not have the mucosa and muscular layer of gallbladder and was composed of fibrous tissues. Coarse granular elevation consisting of necrotic tissues was observed inside. Thus, biloma was diagnosed.

Key words
biloma, cholecystitis

Reprint requests
Kenichi Sakamoto Department of Surgery I, Gifu University School of Medicine 40 Tsukasa-machi, Gifu, 500-8705 JAPAN

Accepted
November 27, 2001

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