Presentation
Bowels not opened for 4 days. Lower abdominal discomfort.
Patient Data
Age: 75 years
Gender: Male
From the case:
Pneumobilia
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/31742/annotated_viewer_json?lang=us"}
Linear gas pattern projected over the liver is in keeping with pneumobilia. Bowel gas pattern is unremarkable.
From the case:
Pneumobilia
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/31743/annotated_viewer_json?lang=us"}
Prominent air cholangiogram is shown with an air-fluid level in the dilated common bile duct and air in the dilated intrahepatic ducts. The gallbladder is absent.
Case Discussion
- differentiating pneumobilia from portal venous gas is important, as the latter is more often associated with life-threatening conditions
- pneumobilia can often be chronic and incidental in setting an appropriate past history (e.g. sphincterotomy)