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A biloma is an encapsulated bile collection outside the biliary tree. Most cases are caused mainly by iatrogenic injury and trauma, and are usually located in the sub-hepatic space. Spontaneous biloma is an uncommon entity. We report three rare cases of spontaneous hepatic subcapsular biloma formation in association with choledocholithiasis in two patients and cholangiocarcinoma in one patient. All the patients presented with extrahepatic biliary obstruction with no previous history of abdominal surgery, instrumentation, or trauma. Ultrasound and computerized tomography of the abdomen documented hepatic subcapsular biloma. The patients were initially managed with antibiotics and radiologically guided pigtail drainage of the collections, followed by definitive treatment of their underlying cause.

Ascariasis, a worldwide parasitic disease, is regarded by some authorities as the most common parasitic infection in humans. The causative organism is Ascaris lumbricoides, which normally lives in the lumen of the small intestine. From the intestine, the worm can invade the bile duct or pancreatic duct, but invasion into the gallbladder is quite rare because of the anatomical features of the cystic duct, which is narrow and tortuous. Once it enters the gallbladder, it is exceedingly rare for the worm to migrate back to the intestine. We report a case of gallbladder ascariasis with worm migration back into the intestine, in view of its rare presentation.