EURORAD ESR

Case 12118

Post-laparoscopic cholecystectomy abdominal wall biloma

Author(s)
Shah A1, Shah R2, Heir MK1 and Botchu R3

1. Department of Radiology,
University Hospitals of Leicester,
NHS Trust, Infirmary Square,
Leicester, LE1 5WW, UK
2 University of Nottingham,
Queen’s Medical Centre,
Nottingham, UK
3 Department of Radiology,
Kettering General Hospital,
Kettering, NN16 8UZ UK
 
Patient
male, 61 year(s)
 
 
  • Figure 1
    Hypodense collection in the right anterolateral abdominal wall and rectus

    Axial CT with intravenous contrast in portovenous phase (70 sec delay) demonstrating low density fluid in the right anterolateral abdominal wall and right rectus sheath (*).

     
    Area of Interest: Abdominal wall; Imaging Technique: CT; Procedure: Education; Special Focus: Pathology;
     
     
  • Figure 2
    Hypodense collection in the right anterolateral abdominal wall and rectus

    Axial CT with intravenous contrast in portovenous phase (70 sec delay), demonstrating an average of 3 Hounsfield Unit of the right abdominal wall collection.

     
    Area of Interest: Abdominal wall; Imaging Technique: CT; Procedure: Education; Special Focus: Pathology;
     
     
  • Figure 3
    Repeat CT resolved abdominal wall collection with new ascites

    Axial CT with intravenous contrast in portovenous phase (70 sec delay) demonstrating resolution of the right rectus sheath collection with a new large ascites (*) and right subphrenic collection (x) with an average of...

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Education; Special Focus: Pathology;
     
     
  • Figure 4
    ERCP with extravasation

    ERCP image demonstrating contrast extravasation in keeping with biliary leak into the abdominal wall (curved arrows). The percutaneous drain is in situ (straight arrows).

     
    Area of Interest: Biliary Tract / Gallbladder; Imaging Technique: Fluoroscopy; Procedure: Cholangiography; Special Focus: Pathology;
     
     
  • Figure 5
    Initial percutaneous drain

    Coronal CT with intravenous contrast in portovenous phase (70 sec delay) demonstrating the percutaneous drain (arrow) in situ in the right hypochondrium with large ascites (*).

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Drainage; Special Focus: Pathology;
     
     
  • Figure 6
    Post drainage and internal biliary stent

    Coronal CT with intravenous contrast in portovenous phase (70 sec delay) demonstrating the biliary stent (long arrow) with near total resolution of ascites and right sub-diaphragmatic collection. The pig tail catheter...

     
    Area of Interest: Abdomen; Imaging Technique: CT; Procedure: Drainage; Special Focus: Pathology;
     
     
Axial CT with intravenous contrast in portovenous phase (70 sec delay) demonstrating low density fluid in the right anterolateral abdominal wall and right rectus sheath (*).
 
Axial CT with intravenous contrast in portovenous phase (70 sec delay), demonstrating an average of 3 Hounsfield Unit of the right abdominal wall collection.
 
Axial CT with intravenous contrast in portovenous phase (70 sec delay) demonstrating resolution of the right rectus sheath collection with a new large ascites (*) and right subphrenic collection (x) with an average of 5HU.
 
ERCP image demonstrating contrast extravasation in keeping with biliary leak into the abdominal wall (curved arrows). The percutaneous drain is in situ (straight arrows).
 
Coronal CT with intravenous contrast in portovenous phase (70 sec delay) demonstrating the percutaneous drain (arrow) in situ in the right hypochondrium with large ascites (*).
 
Coronal CT with intravenous contrast in portovenous phase (70 sec delay) demonstrating the biliary stent (long arrow) with near total resolution of ascites and right sub-diaphragmatic collection. The pig tail catheter is also demonstrated (small arrow).
 
 
 
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