Surgery 163 (2018) 965–966 Contents lists available at ScienceDirect Surgery journal homepage: www.elsevier.com/locate/ymsy Images in Surgery a, b a a Joseph G. Crompton *, Jaime M. Jimenez , Formosa Chen , and O. Joe Hines Department of Surgery, University of California, Los Angeles, Los Angeles, CA David Geffen School of Medicine at UCLA, Los Angeles, CA ARTICLE INF O Article history: Accepted 12 September 2017 Available online 3 January 2018 Fig. 1. (A) Computed tomographic image with intravenous and oral contrast showing pneumobilia and a loculated collection in the left hepatic lobe measuring 5.1 × 4.5 cm. (B) Magnetic resonance cholangiopancreatography with intravenous and oral contrast showing a biliary enteric communication and ill-deﬁned hypointense ﬁlling defects with intra- and extrahepatic biliary tree. A50-year-old man presented with severe sepsis, abdominal pain, and recommended endoscopic clearance of the bile duct and and jaundice. A computed tomographic scan showed a liver abscess sphincterotomy. and pneumobilia (Fig 1, A). The patient reported cholecystectomy in Philippines 20 years prior, but could not provide additional op- Discussion erative details. Magnetic resonance cholangiopancreatography demonstrated a biliary-enteric communication between the Biliary sump syndrome is a complication of biliary-enteric anas- proximal duodenum and common bile duct with ill-deﬁned
Surgery – Elsevier
Published: Apr 1, 2018
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