case_images: PMC4286822_01
case_images: 35-year-old woman underwent orthotopic liver transplantation for autoimmune hepatitis-induced cirrhosis associated with secondary portal hypertension and was diagnosed with postoperative biliary anastomotic leakage. Corresponding axial (a) T1-weighted and (b) T2-weighted sequences of the upper abdomen show left perihepatic fluid collection (arrow) with a low T1 signal and high T2 signal.
case_images: JCIS-4-75-g002.jpg
case_images: PMC4286822_01_JCIS-4-75-g002.jpg
case_images: F1
case_images: T1 and high T2 signal fluid collection was present in the left perihepatic space indicating a biloma [Figure 1]. The biliary anastomosis was well identified between the common hepatic duct and the jejunal loop of the Roux-en-Y hepaticojejunostomy.
case_images: 35-year-old woman underwent orthotopic liver transplantation for autoimmune hepatitis-induced cirrhosis associated with secondary portal hypertension and was diagnosed with postoperative biliary anastomotic leakage. Axial T1 image 45 min post-Primovist injection shows high T1 signal bile pooling (arrow) within the left perihepatic space.
case_images: JCIS-4-75-g003.jpg
case_images: PMC4286822_01_JCIS-4-75-g003.jpg
case_images: F2
case_images: Following Primovist administration, a high-grade bile leak was confirmed at the surgical anastomosis with extravasation of high T1 signal bile from the biliary tree, bypassing the jejunal loop, pooling within the perihepatic space biloma, left subphrenic space, and extending down the left paracolic gutter into the left side of the pelvis [Figures 2 and 3].
case_images: 35-year old woman underwent orthotopic liver transplantation for autoimmune hepatitis-induced cirrhosis associated with secondary portal hypertension and was diagnosed with postoperative biliary anastomotic leakage. Coronal T1 MIP image 45 min post-Primovist injection shows high T1 signal bile pooling from biliary tree at the anastomotic site (arrow) and within the left perihepatic and subphrenic spaces.
case_images: JCIS-4-75-g004.jpg
case_images: PMC4286822_01_JCIS-4-75-g004.jpg
case_images: F3
case_images: Following Primovist administration, a high-grade bile leak was confirmed at the surgical anastomosis with extravasation of high T1 signal bile from the biliary tree, bypassing the jejunal loop, pooling within the perihepatic space biloma, left subphrenic space, and extending down the left paracolic gutter into the left side of the pelvis [Figures 2 and 3].