Biloma Accompanied by Acute Cholecystitis

Biloma, a secondary cyst collecting bile in the subserosal space of the liver, is generally caused by injury to the liver and the bile duct due to trauma or surgery. However we have encountered 3 rare cases of biloma caused by acute cholecystitis. In one patient; the biloma disappeared spontaneously before conservative surgery was performed. In the second patient; the biloma was drained before surgery, but marked changes were not noted. In the third patient; the biloma disappeared after drainage of the gall bladder. The findings seen in these 3 cases suggest that the bile in biloma would spontaneously drain into the gall bladder if inflammation of the gall bladder was reduced by some sort of treatment. Therefore it is considered that removal or drainage of the diseased gall bladder causing the biloma is the most effective treatment of this entitiy.