Noninvasive evaluation of bile leakage.

Three patients had internal biliary leakage demonstrated by hepatobiliary scintigraphy. In two, it was secondary to trauma and in one patient, it was related to spontaneous bile leakage of unknown causation. Although ultrasound of the abdomen is a highly accurate modality for the detection and anatomic localization of cystic collections, the ultrasonic features of a biloma are identical to those of other cystic lesions in the abdomen. In many patients, hepatobiliary and gallium scintigraphy ca help in the differentiation between biloma and abscesses. These patients stressed the need for hepatobiliary imaging, multiple projections and delayed views for the detection and localization of abnormal collections of bile. The biliary excretion of gallium should be taken into consideration when interpreting these scans.