Nursing Management and Clinical Implications of Hepatic Biloma in Adult Patients

Background: Hepatic biloma is an uncommon but clinically significant condition resulting from disruption of the biliary tree and subsequent bile leakage into intrahepatic or extrahepatic spaces. It occurs most frequently following iatrogenic hepatobiliary procedures and trauma, and delayed recognition may lead to infection, sepsis, or organ compression. Aim: This article aims to review the etiology, pathophysiology, clinical presentation, evaluation, management strategies, and nursing implications of hepatic biloma in adult patients, with emphasis on early recognition and multidisciplinary care. Methods: A comprehensive narrative review of existing clinical literature, observational studies, case series, and imagingbased reports was conducted to synthesize current knowledge regarding hepatic biloma. Emphasis was placed on diagnostic modalities, therapeutic approaches, and patient outcomes relevant to clinical and nursing practice. Results: Bilomas most commonly arise after laparoscopic cholecystectomy, endoscopic retrograde cholangiopancreatography, liver ablation, and transplantation. Clinical manifestations are often nonspecific, ranging from mild abdominal discomfort to sepsis. Imaging, particularly ultrasound and computed tomography, remains the cornerstone of diagnosis. Management is individualized; small, asymptomatic bilomas may resolve with observation, while larger or symptomatic collections typically require imageguided percutaneous or endoscopic drainage. Early intervention is associated with favorable outcomes and low recurrence rates. Conclusion: Hepatic biloma requires a high index of suspicion, particularly following biliary interventions. Prompt imaging, timely drainage, and coordinated multidisciplinary management are essential to prevent complications. Nurses play a pivotal role in early detection, monitoring, patient education, and postintervention care.