Spontaneous biloma manifesting with massive upper gastrointestinal bleed: case report

Spontaneous biloma is a rare non-traumatic lesion in whi­ch the extrahepatic or intrahepatic bile duct perforates spontaneously with no discernable cause. We present case of spontaneous 68 years old male patient cholelithiasis and concurrent choledocholithiasis, who presented acute severe cholangitis. There was history abdominal surgery, instrumentation, trauma past. Initial ultrasonography (USG) abdomen showed central dilation, cholelithiasis, choledocholithiasis. A sizeable hypoechoic few internal septations adjacent to left lobe liver, USG suspicion hydatid cyst. The abutting displacing stomach anteromedially. had an renal failure hemodynamic instability at presentation. managed emergency endoscopic drainage under ultrasound guidance improved after that. On fourth day, drainage, massive upper gastrointestinal (UGI) bleed due erosion pressure necrosis gastric wall biloma. successfully sleeve gastrectomy de-roofing