Presentation
Bowels not opened for 4 days. Lower abdominal discomfort.
Patient Data
Age: 75 years
Gender: Male
From the case:
Pneumobilia
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Linear gas pattern projected over the liver is in keeping with pneumobilia. Bowel gas pattern is unremarkable.
From the case:
Pneumobilia
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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)
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