Introducción: El biloma se define como la
fuga de
bilis intrahepática, extrahepática y a veces retroperitoneal, asintomático o de
sintomatología variable, la presencia del biloma subcapsular hepático en un
paciente con
pancreatitis crónica no ha sido informada en la
literatura . Caso clínico Hombre de 52 años de edad, alcohólico. Se realiza
colecistectomía laparoscópica por
colecistolitiasis sintomática, reingreso precoz por presentar
vómitos , distensión abdominal,
ictericia y
tumor abdominal doloroso en hemiabdomen superior, el ultrasonograma (US) y la
tomografía computarizada (TC) helicoidal abdominal muestran una colección en lóbulo hepático derecho, se realiza
drenaje percutáneo (DP), en la
colangiopancreatografía retrógrada endoscópica (CPRE) no se observa
fuga biliar,
anatomía biliar normal,
conducto pancreático principal dilatado difusamente con
estenosis dispersas. Se realiza
esfinterotomía y
drenaje .
Conclusiones: No existen reportes de la coexistencia entre biloma subcapsular hepático y
pancreatitis crónica luego de la
colecistectomía laparoscópica , no pensamos que esta sea una relación casual, se exponen factores que justifican la misma.
Background: Bilomas is the intra-hepatic, extra-hepatic and sometimes retroperitoneal collection for
bile leak, variable clinic or asymptomatic. However, the clinical
association between hepatic sub-capsular bilomas and
chronic pancreatitis never has seen to be
reports elsewhere in the
literature . Clinical case A 52-year-old
alcoholic man
who was operated of
laparoscopic cholecystectomy for symptomatic
cholelithiasis , readmitted for
vomiting , abdominal distension, ictericia,
abdominal pain tumour in superior
abdomen , the ultrasound(US) and helicoidally
computer tomography (CT) show the collection in right hepatic lobule, it was evacuated for percutaneous
drainage , in
endoscopic retrograde cholangiopancreatography (CPRE) no observed
bile leak, biliar
tree was normal, the
main pancreatic duct appeared diffusely dilated with scattered
strictures , and finished with
endoscopic sphincterotomy and
drainage .
Conclusions: There are no
reports of a clinical
association between hepatic sub-capsular bilomas and
chronic pancreatitis after
laparoscopic cholecystectomy . We believe that there is a physiopathological relationship between then and exposed the facts.