Abstract
A biloma is defined as an abnormal collection of bile in an intrahepatic or extrahepatic location secondary to a rupture of the biliary system, either spontaneous or posttraumatic. It can lead to significant morbidity and mortality if timely diagnosis and management is not done. We will be discussing a case of a 70-year-old male who presented to the hospital with pain in the right hypochondriac region and fever. Clinical examination and laboratory tests were nonspecific. Ultrasonography was carried out, which revealed an intrahepatic hypoechoic cystic lesion with internal echoes and debris in the right lobe of the liver. A provisional diagnosis of hepatic abscess was made. However, pigtail catheter insertion and magnetic resonance cholangiopancreatography performed later on identified the correct diagnosis, which was biloma.