A rare case of biloma after ascending cholangitis and endoscopic retrograde cholangiopancreatography
  • Laura Hernandez Perez
    Department of Internal Medicine, New York Medical College at St. Michael’s Medical Center, Newark, USA
  • Aishwarya Chandra
    Department of Internal Medicine, New York Medical College at St. Michael’s Medical Center, Newark, USA
  • Ruhma Ali
    Department of Pulmonology and Critical Care, New York Medical College at St. Michael’s Medical Center, Newark, USA
  • Hari Sharma
    Department of Pulmonology and Critical Care, New York Medical College at St. Michael’s Medical Center, Newark, USA
  • Richard Miller
    Department of Pulmonology and Critical Care, New York Medical College at St. Michael’s Medical Center, Newark, USA
  • Muhammad Hussain
    Department of Gastroenterology and Hepatology, New York Medical College at St. Michael’s Medical Center, Newark, USA

Keywords

Diseases of the bile ducts, biloma, endoscopic retrograde cholangio pancreatography, ERCP, ascending cholangitis

Abstract

Introduction: Biloma is an uncommon form of liver abscess composed of bile usually associated with procedures of the biliary tree and gallbladder. Cholangitis can be acute or chronic, can result in partial or complete obstruction of the flow of bile. The infection of the bile is so common, that positive blood cultures are highly characteristic. In the case of a suppurative cholangitis with signs of sepsis treatment alone with antibiotics is usually not sufficient to achieve medical remission. Multiple hepatic abscesses are often present, and the mortality approaches 100% unless prompt endoscopic or surgical relief of the obstruction and drainage of infected bile are carried out. Endoscopic retrograde cholangiopancreatography ERCP with endoscopic sphincterotomy is the preferred initial procedure for both establishing a definitive diagnosis and providing effective therapy.
Case description: We present the case of a 69-year-old female patient with complex chronic comorbidities who presented with acute cholangitis initially managed with endoscopically inserted stent and later complicated by sepsis and biloma formation. The bile was drained, and it showed an infection with Candida spp. requiring antifungal therapy.
Conclusions: The failure to perform sphincterotomy in patients with suppurative cholangitis can contribute to the backflow of bile and worse outcomes.

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References

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    Published: 2024-05-02
    Issue: 2024: Vol 11 No 6 (view)


    How to cite:
    1.
    Hernandez Perez L, Chandra A, Ali R, Sharma H, Miller R, Hussain M. A rare case of biloma after ascending cholangitis and endoscopic retrograde cholangiopancreatography. EJCRIM 2024;11 doi:10.12890/2024_004482.

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