Delayed Presentation of a Postoperative Biloma Requiring Multimodal Intervention in an Elderly Female: A Case Report

Biloma is a rare but serious postoperative complication, often resulting from iatrogenic bile duct injury. We present the case of an 81-year-old woman with a delayed presentation of biloma complicated by sepsis, who required both interventional radiology (IR)-guided drainage and endoscopic retrograde cholangiopancreatography (ERCP) with biliary stenting for management. There was a delay in diagnosis and management for this case, particularly due to a combination of subtle clinical signs, language and hearing barriers, and limited patient understanding of management. This report emphasizes the importance of multidisciplinary care, culturally competent communication, and flexibility in managing bile leaks in older adults.