P-BN30 Retroperitoneal biloma: a case report of spontaneous retroperitoneal bike leak and collection

Abstract Background Retroperitoneal biloma is a rare complication of gallstone disease. Only handful cases have been reported in the literature with various mechanisms postulated. Here, we report case spontaneous retroperitoneal arising from gallbladder perforation. Methods An 87-year-old female patient presented right upper quadrant pain context known Inflammatory markers and liver function tests were deranged. Cross sectional imaging found acute cholecystitis gallbadder neck perforation an impacted 2cm proximal common bile duct (CBD) stone. A cholecystostomy was placed she improved clinically. However, inflammatory remained high, subsequent computed tomography (CT) large collection retroperitoneum. Results The measured 14cm x 7cm, there had evidence on prior CT scans inflammation. It urgently drained under ultrasound guidance to contain bilious content. Subsequent endoscopic retrograde cholangiopancreatography (ERCP) unable retrieve CBD stone, but left stents either side clinically biochemically improved. She discharged elective ERCP, which successfully retrieved plan for urgent laparoscopic cholecystectomy. Conclusions interesting managed ultrasound-guided drainage. Perforation distal can result leak, stone this would likely prevented passage bile. more cause adhesion posterior parietal peritoneum due chronic inflammation, release into This has previously described literature. Regardless mechanism, knowledge potential important anticipating appropriately managing complications