Pneumobilia

The radiologic finding of gas within the intrahepatic or extrahepatic biliary tree.

Causes

• Biliary-enteric communication

  • Biliary-enteric fistula due to an eroding gallstone

  • Cholecystoenteric fistula

  • Choledochoenteric fistula

• Iatrogenic causes

  • Endoscopic retrograde cholangiopancreatography (ERCP)

  • Endoscopic sphincterotomy

  • Whipple procedure (pancreaticoduodenectomy)

  • Liver transplantation with biliary-enteric reconstruction

  • Biliary stent placement

  • Percutaneous transhepatic biliary drainage

• Functional causes

  • Malfunctioning sphincter of Oddi

  • Postsphincterotomy sphincter incompetence

• Emphysematous cholangitis

• Traumatic bile duct injury