Non-traumatic perforation of common hepatic duct: Case report and review of literature HP

Atwez, Abdelaziz; Augustine, Matthew R.; Nottingham, James

doi:10.1016/j.ijscr.2017.10.023

Cited by 3 publications

(10 citation statements)

References 4 publications

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“…Magnetic resonance imaging shows that bile, urine, and abscess are all high‐intensity signals on T2‐weighted intensity and low‐intensity signals on T1‐weighted intensity, which are not useful for differentiation. Magnetic resonance cholangiopancreatography evaluates bile duct stricture, and hepatobiliary iminodiacetic acid scan is a useful and recommended imaging test for bile leakage identification 13 . Retroperitoneal biloma demonstrated atypical clinical symptoms, and it is frequently difficult to make a definitive diagnosis based on imaging only.…”

Section: Discussionmentioning

confidence: 99%

Retroperitoneal biloma—A rare differential diagnosis of perirenal fluid accumulation

Hanawa,

Fukasawa,

Aoki

et al. 2024

IJU Case Reports

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IntroductionNontraumatic biliary rupture and retroperitoneal biloma infrequently occur. Here, we report a case of retroperitoneal biloma due to spontaneous left hepatic duct perforation, which was difficult to differentiate from a perirenal abscess.Case presentationA 94‐year‐old female patient was hospitalized with symptoms of fatigue and right back pain that lasted for 5 days. Computed tomography revealed fluid accumulation in the retroperitoneum, and urinary extravasation and right perinephric abscess were suspected. Antimicrobial treatment and drainage with ureteral stents and urethral catheters demonstrated no symptom improvement. Ultrasound‐guided puncture of the abscess revealed the presence of bile. Pigtail catheter drainage improved symptoms and inflammatory response. After diagnosis, endoscopic retrograde cholangiopancreatography revealed bile leakage, and a bile duct stent was inserted.ConclusionBiloma can cause perirenal fluid accumulation, and they should be considered an origin of perirenal fluid accumulation when urinary tract lesions are excluded.

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Section: Discussionmentioning

confidence: 99%

Retroperitoneal biloma—A rare differential diagnosis of perirenal fluid accumulation

Hanawa,

Fukasawa,

Aoki

et al. 2024

IJU Case Reports

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“…Percutaneous aspiration under radiologic guidance, as well as ERCP can aid both in diagnosis and treatment. Indeed, impacted stones in the biliary tree need to be extracted to avoid pressure necrosis and spontaneous perforation, and can be complemented with biliary stent placement [5] . Although it was not available in this case, the hepatobiliary iminodiacetic acid scan is considered to be the most effective diagnostic imaging modality in the identification of bile leak [5] .…”

Section: Discussionmentioning

confidence: 99%

“…A biloma is a collection of bile outside the biliary tree, that can be either intra- or extrahepatic [4] . Clinical presentation may range from an insidious course, where painless abdominal distension and increasing jaundice are the main symptoms, to an acute presentation with fulminant biliary peritonitis, septic shock and multi-organ failure [3] , [5] .…”

Section: Introductionmentioning

confidence: 99%

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Spontaneous retroperitoneal biloma in a patient with choledocholithiasis: Presentation of case

Costa¹,

Pimentel²,

Silva³

et al. 2023

International Journal of Surgery Case Reports

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“…The purpose of surgical treatment is to prevent persistent contamination by controlling bile leakage, draining the peritoneal cavity, and restoring biliary tract patency. The pathological causes of the biliary tract leading to perforation must be resolved as early as possible through laparotomy, laparoscopy, or robotic technology ( 28 ). Among the 24 patients who underwent surgery in our study, the choice between intraoperative cholecystostomy and common bile duct external T-tube drainage mainly depended on the intraoperative status of porta hepatis.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the Clinical Characteristics of Spontaneous Bile Duct Perforation in Children

et al. 2022

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ObjectiveThis study aimed to explore the etiology, clinical features, diagnosis, and treatment of spontaneous bile duct perforation (SBDP) in children.MethodsThe clinical data of children with SBDP who were admitted to Wuhan Children's Hospital between January 2014 and January 2020 were retrospectively analyzed.ResultsIn all, 28 cases of children with SBDP (male, 28.6%; female, 71.4%; male-to-female ratio, 1:2.5; average age, 2.15 years) were analyzed. The most common symptoms were fever (85.7%), nausea and vomiting (78.6%), and abdominal distension (67.9%). Among the 28 patients, 26 (92.9%) had elevated hypersensitive C-reactive protein, 24 (85.7%) had an increased neutrophil percentage, and 22 (78.6%) had raised peripheral blood leukocyte counts. Moreover, 19 patients (67.9%) showed increased serum total bilirubin levels, and 5 (17.9%) showed an elevated conjugated bilirubin level. Abdominal CT examination revealed that the gallbladder wall of patients was thickened with edema, accompanied by gallbladder stenosis and gallbladder mucosa enhancement; furthermore, ascites was found in the abdominal cavity and lesser omental bursa. Twenty-two patients underwent abdominal paracentesis, and 20 (90.9%) of them were exposed to bile-based ascites. Among the 28 patients, four recovered with conservative treatment, whereas the others (85.7%) were surgically treated. Of the twenty-four patients undergoing surgery, the perforation site was found at the union of the hepatic and cystic ducts in 12 patients (50%), no perforation site was observed in 9 patients (37.5%), and a common hepatic duct was observed in 3 patients (12.5%). All 24 patients underwent stage I surgery, and temporary biliary drainage was performed because of severe abdominal inflammation. Cholangiography and enhanced CT revealed an abnormal location of the pancreatic duct joining the bile duct in 64.3% patients. Following surgery, 15 patients underwent hepaticojejunostomy. Subsequently, 3-month to 6-year follow-up (median, 30 months) indicated that the patients recovered well with no serious complications.ConclusionSBDP in children may be associated with pancreaticobiliary malunion (PBM) and congenital weakness of the bile duct wall. However, the clinical manifestations of this condition lack specificity; this limitation can be assisted through diagnosis via abdominal CT and by performing abdominal paracentesis. Once SBDP diagnosis is confirmed, the patient should follow the principles of individualized treatment.

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Non-traumatic perforation of common hepatic duct: Case report and review of literature HP

Cited by 3 publications

References 4 publications

Retroperitoneal biloma—A rare differential diagnosis of perirenal fluid accumulation

Retroperitoneal biloma—A rare differential diagnosis of perirenal fluid accumulation

Spontaneous retroperitoneal biloma in a patient with choledocholithiasis: Presentation of case

Analysis of the Clinical Characteristics of Spontaneous Bile Duct Perforation in Children

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