University of Maryland School of Medicine logo
Emergency Medicine
All Departments
UMSOM Assistant
UMEM Educational Pearls
  • Home
  • Departments
  • Emergency Medicine
  • CME
  • UMEM Educational Pearls
  • CME
  • Courses and Conferences
  • Free Open Access Medical Education
  • UMEM Educational Pearls

Search

Title: What's the Diagnosis? Guest submission by #ChileEM Dr. Pedro Verdugo

Category: Visual Diagnosis

Posted: 1/11/2016 by Haney Mallemat, MD (Updated: 3/10/2016)

Question

What’s the name of this CT finding and name two potential causes?

Answer

Pneumobilia (air in the biliary tree). Be careful, this must be distinguished from portal venous gas.

Diagnoses to consider when pneumobilia is present:

  • Infection
    • Cholangitis
    • Liver abscess communicating with biliary tree
    • Emphysematous cholecystitis
  • Biliary instrumentation (e.g., recent ERCP)
  • Incompetent sphincter or Oddi
    • passage of a gallstone
    • sphincterotomy
    • certain medications
  • Biliary-enteric fistula (e.g., Peptic ulcer disease, gallstone ileus, trauma,, etc.)

http://radiopaedia.org/articles/pneumobilia

References

Follow me on Twitter (@criticalcarenow)

 

 

University of Maryland School of Medicine logo
  • Departments
  • Programs
  • Research Centers
  • Institutes
  • Graduate Education
  • CIBR Cores
  • Offices of the Dean
    • University of Maryland, Baltimore
    • University of Maryland Medical Center
    • Medical Alumni Association of the University of Maryland
    • Health Sciences and Human Services Library
University of Maryland School of Medicine
655 W. Baltimore Street
Baltimore, MD 21201
Contact Us

© University of Maryland School of Medicine

    • Webmaster
    • Web Accessibility
    • Site Index
    • UMB Hotline
    • Employment
    • Map