An 80-year-old man was admitted to a local hospital with jaundice. Computed tomography (CT) (Picture 1) revealed bile duct dilatation. Endoscopic retrograde cholangiography (ERC) (Picture 2) without a guidewire revealed a common bile duct stone; however, it was unable to be removed because of the patient's body motion caused by insufficient sedation. After three weeks, he developed abdominal distention with pain and was referred to our hospital one week later. Subsequent CT revealed an intra-abdominal mass connected to the liver capsule and compressing the liver parenchyma (Picture 3). We performed percutaneous drainage, and a large amount of dark brown bile was discharged through the drainage tube. Eight days later, ERC revealed no bile leakage (Picture 4) and the bile duct disruption improved within a month. We speculate that a rare case of bile leakage occurred in this patient following contrast injection without stone extraction, with consequent excessive bile duct pressure.
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The authors state that they have no Conflict of Interest (COI).