RT Journal
A1 Magge D, Tsung A, Geller DA
T1 IMage of the month—quiz case
JF Archives of Surgery
JO Archives of Surgery
YR 2010
FD November 15
VO 145
IS 11
SP 1123
OP 1123
DO 10.1001/archsurg.2010.236-a
UL http://dx.doi.org/10.1001/archsurg.2010.236-a
AB 
A 50-year-old woman who had laparoscopic cholecystectomy for symptomatic cholelithiasis at an outside hospital developed symptoms of abdominal pain, nausea, and vomiting 1 week postoperatively. She initially underwent an abdominal ultrasound, which did not reveal any abnormalities. Subsequent endoscopic retrograde cholangiopancreatography (ERCP) also failed to reveal the cause of her symptoms. An abdominal computed tomographic scan was then performed, which demonstrated a biloma adjacent to the gallbladder fossa. A percutaneous abdominal catheter was placed and drained approximately 400 to 500 mL of bile per day. After a second ERCP was performed, which again failed to delineate a bile leak, the patient was transferred to our institution for further treatment.