Intrahepatic biloma from ruptured cholecystitis
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Intrahepatic biloma is a rare complication of perforated acute cholecystitis. Early and accurate detection has a significant impact on clinical management. Imaging and Interventional radiology play an important role in the diagnosis and management of complicated perforated acute cholecystitis. A 78-year-old man with a past medical history of rectal cancer presented to the emergency department with Fever, upper abdominal pain, increasing confusion, and urinary incontinence. The patient was admitted for urinary tract infection and given intravenous antibiotics. Contrast-enhanced CT of the abdomen with coronal reconstructions demonstrates a 3.5 cm intrahepatic fluid collection in the right hepatic lobe. Multiple gallstones are present within this fluid collection. Review of the axial images reveals a direction communication between the posterior inferior wall of the gallbladder and the fluid collection.Investigations confirmed the diagnosis-ruptured cholecystitis with intrahepatic biloma containing multiple gallstones.

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