Biliomas are encapsulated collections of bile outside the biliary tree, caused mainly by trauma to the liver or bile ducts, or by acute obstruction of them, and not infrequently without an apparent cause. We present an 86 y.o. female patient who comes to the ER with right upper quadrant abdominal pain, fever and jaundice. Gallbladder had been removed previously but she had a dilated bile duct consistent with choledocolithiasis. Surgery was performed when she developed peritonitis and a sub-hepatic bilioma was found.