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Massive biloma presenting as gastric outlet obstruction.

Gorospe EC, Leggett CL, Nadkarni NA - Ann Gastroenterol (2012)

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology and Hepatology, St' Mary's Hospital, Rochester, Minnesota, USA.

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Bile leaks are an important cause of morbidity after living donor liver transplantation (LDLT)... This complication occurs in the early postoperative period and has an incidence of 15-40%... These images (Figs. 1 and 2) are from a 57-yearold female who presented with symptoms of gastric outlet obstruction and was found to have a massive biloma... The liver transplantation was performed with a biliary duct-to-duct anastomosis with unremarkable immediate perioperative course... Two weeks after transplantation, she began to complain of abdominal fullness, nausea and vomiting... On admission, a CT abdomen revealed a large fluid collection in the lesser sac, resulting in almost complete gastric compression (Fig. 1)... CT-guided aspiration and placement of a 10-French locking loop pigtail catheter drained 1 L of bilious fluid... Cholangiography confirmed a native distal bile duct with narrowing at the anastomosis... This was accessed with a guidewire, dilated with a 4-mm balloon and stented with a 7-French plastic stent... The percutaneous drainage output subsequently decreased with improvement in abdominal fullness and nausea, prompting discontinuation of the percutaneous drain... The treatment of biloma may require either endoscopic management or percutaneous intervention... Surgical drainage and bile duct repair may be warranted in cases of persistent biloma after endoscopic intervention.

No MeSH data available.


Related in: MedlinePlus

Bile leak above the duct anastomosis
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Figure 2: Bile leak above the duct anastomosis

Mentions: Bile leaks are an important cause of morbidity after living donor liver transplantation (LDLT). This complication occurs in the early postoperative period and has an incidence of 15-40% [1]. These images (Figs. 1 and 2) are from a 57-yearold female who presented with symptoms of gastric outlet obstruction and was found to have a massive biloma. She had undergone a LDLT for hepatitis C cirrhosis one month prior to presentation. The liver transplantation was performed with a biliary duct-to-duct anastomosis with unremarkable immediate perioperative course. Two weeks after transplantation, she began to complain of abdominal fullness, nausea and vomiting.


Massive biloma presenting as gastric outlet obstruction.

Gorospe EC, Leggett CL, Nadkarni NA - Ann Gastroenterol (2012)

Bile leak above the duct anastomosis
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3959387&req=5

Figure 2: Bile leak above the duct anastomosis
Mentions: Bile leaks are an important cause of morbidity after living donor liver transplantation (LDLT). This complication occurs in the early postoperative period and has an incidence of 15-40% [1]. These images (Figs. 1 and 2) are from a 57-yearold female who presented with symptoms of gastric outlet obstruction and was found to have a massive biloma. She had undergone a LDLT for hepatitis C cirrhosis one month prior to presentation. The liver transplantation was performed with a biliary duct-to-duct anastomosis with unremarkable immediate perioperative course. Two weeks after transplantation, she began to complain of abdominal fullness, nausea and vomiting.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology and Hepatology, St' Mary's Hospital, Rochester, Minnesota, USA.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Bile leaks are an important cause of morbidity after living donor liver transplantation (LDLT)... This complication occurs in the early postoperative period and has an incidence of 15-40%... These images (Figs. 1 and 2) are from a 57-yearold female who presented with symptoms of gastric outlet obstruction and was found to have a massive biloma... The liver transplantation was performed with a biliary duct-to-duct anastomosis with unremarkable immediate perioperative course... Two weeks after transplantation, she began to complain of abdominal fullness, nausea and vomiting... On admission, a CT abdomen revealed a large fluid collection in the lesser sac, resulting in almost complete gastric compression (Fig. 1)... CT-guided aspiration and placement of a 10-French locking loop pigtail catheter drained 1 L of bilious fluid... Cholangiography confirmed a native distal bile duct with narrowing at the anastomosis... This was accessed with a guidewire, dilated with a 4-mm balloon and stented with a 7-French plastic stent... The percutaneous drainage output subsequently decreased with improvement in abdominal fullness and nausea, prompting discontinuation of the percutaneous drain... The treatment of biloma may require either endoscopic management or percutaneous intervention... Surgical drainage and bile duct repair may be warranted in cases of persistent biloma after endoscopic intervention.

No MeSH data available.


Related in: MedlinePlus