Acute Biliary Disorders and Complications

Hepatobiliary emergencies include both traumatic and nontraumatic pathologies that can affect the gallbladder, bile ducts, and liver. Due to the complexity and urgency of these conditions, advanced imaging techniques are required for rapid, accurate diagnosis. Traumatic liver emergencies were historically treated surgically; however, with the implementation of contrast-enhanced computed tomography (CT), management options have evolved. Contrast-enhanced CT imaging can provide additional insight into the extent and severity of injuries, enabling clinicians to decide between operative and nonoperative management with greater confidence. Furthermore, nontraumatic biliary emergencies present diagnostic challenges due to the diversity in their clinical presentations. When biliary pathology is suspected, the use of ultrasound, CT, and magnetic resonance imaging (MRI) aids in differentiating between conditions such as acute cholecystitis, acalculous cholecystitis, gangrenous cholecystitis, and emphysematous cholecystitis, thereby directing management strategies. Moreover, liver pathologies such as liver abscesses, hemorrhagic liver lesions, and vascular disorders demand integrated imaging assessments. The combination of ultrasound, CT, and MRI facilitates the differentiation between pyogenic and parasitic abscesses, evaluation of spontaneous liver ruptures, and diagnosis of portal vein thrombosis and Budd-Chiari syndrome, guiding clinical interventions. In addition, biloma and cholangitis, while less frequent, require precise diagnosis. The use of multimodality imaging enables early detection and intervention while mitigating potential complications. In conclusion, this review highlights the key role of advanced imaging in hepatobiliary emergencies and provides a comprehensive overview to help clinicians navigate complex scenarios effectively.