Management of Intra-Abdominal Biloma in the Setting of Chronic Steroid Use for Nephrotic Syndrome

Workup included a noncontrast CT scan of the abdomen which revealed a large intra-abdominal fluid collection measuring 25 x 11 x 28 cm with no definitive visualization of the gallbladder. [...]evaluation with magnetic resonance cholangiopancreatography endoscopic retrograde cholangiopancreatography (ERCP) (Fig. 2), and drain studies indicated that this was a biloma suspected secondary to a fistulous communication with the gallbladder. Intraoperatively, dense inflammation with poor definition of anatomical planes necessitated subtotal cholecystectomy to prevent damage to portal structures, including the common bile duct.