Case contributed by RMH Core Conditions


Bowels not opened for 4 days. Lower abdominal discomfort.

Patient Data

Age: 75 years
Gender: Male

Linear gas pattern projected over the liver is in keeping with pneumobilia. Bowel gas pattern is unremarkable.


Prominent air cholangiogram is shown with an air-fluid level in the dilated common bile duct and air in the dilated intrahepatic ducts. The gallbladder is absent. 

Case Discussion

  • differentiating pneumobilia from portal venous gas is important, as the latter is more often associated with life-threatening conditions
  • pneumobilia can often be chronic and incidental in setting an appropriate past history (e.g. sphincterotomy) 
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Case information

rID: 31038
Published: 18th Sep 2014
Last edited: 16th Feb 2016
Inclusion in quiz mode: Included

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