Spontaneous hepatic subcapsular biloma: Report of three cases with review of the literature

Bilioma, safra yolu d›fl›nda yerleflen kapsullu safra kolleksiyonudur. Bunlar›n buyuk counluu iatrojenik nedenlere veya travma- ya bal› olarak geliflir ve genellikle subhepatik bofllukta yerleflirler. Spontan bilioma nadir gorulen bir durumdur. Burada nadir gorulen, ikisi koledokolitiyazise ve biri kolanjiokarsinoma sekonder geliflen spontan hepatik subkapsuler bilioma vakas› sunulmufl- tur. Tum hastalar ekstrahepatik biliyer obstruksiyon ile baflvurmufltur ve hicbirinde abdominal cerrahi oykusu, enstrumentasyon veya travma oykusu yoktur. Hepatik subkapsuler biliomalar›n tan›mlanmas›nda ultrasonografi ve bilgisayarl› tomografi kullan›l- m›flt›r. Hastalar ilk olarak antibiyotik ve radjoloji klavuzluunda pig-tail katater drenaj› ile tedavi edilmifl ve ertesinde alt yatan etkenin ozgul tedavisi yap›lm›flt›r. Anahtar kelimeler: Bilioma, hepatik, subkapsuler, koledokolitiyazis, kolanjiyokarsinoma A biloma is an encapsulated bile collection outside the biliary tree. Most cases are caused mainly by iatrogenic injury and trauma, and are usually located in the sub-hepatic space. Spontaneous biloma is an uncommon entity. We report three rare cases of sponta- neous hepatic subcapsular biloma formation in association with choledocholithiasis in two patients and cholangiocarcinoma in one patient. All the patients presented with extrahepatic biliary obstruction with no previous history of abdominal surgery, instrumen- tation, or trauma. Ultrasound and computerized tomography of the abdomen documented hepatic subcapsular biloma. The patients were initially managed with antibiotics and radiologically guided pigtail drainage of the collections, followed by definitive treat- ment of their underlying cause.