RESUMO
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.
Assuntos
Humanos , Masculino , Feminino , Colangiografia , Colecistectomia Laparoscópica , Pancreatite CrônicaRESUMO
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 (AU)
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 (AU)
