Spontaneous perforation of the common hepatic duct

Gough, A L; Edwards, A N; Keddie, Nigel

doi:10.1002/bjs.1800630609

Cited by 14 publications

(7 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…5,6 There are many etiological proposals given to explain the occurance of spontaneous bile duct perforation such as; bile duct obstruction due to stones, tumors or stricture with raised intraductal pressure; stones or tumors directly eroding the bile duct wall; bile duct diverticulum; vascular insufficiency to biliary tree. [7][8][9][10] It is seen that bile duct stones is the most common cause of bile duct perforation. 11 The raised intraductal pressure proximally in the biliary tree leads to spontaneous perforation at vulnerable points.…”

Section: Discussionmentioning

confidence: 99%

A case report of spontaneous biliary peritonitis with accessory liver lobe: rare presentation of a rare pathology

et al. 2021

View full text Add to dashboard Cite

Spontaneous intrahepatic bile duct perforation with associated accessory liver lobe is an exceedingly rare condition with very few cases reported in the literature. Here we report a case of 76 years old man presenting with severe pain, abdominal distension since 3 days having jaundice and signs of peritonitis. Having undergone an exploratory laparotomy, 1 liter of bilious peritoneal fluid was seen with a perforation of left intra hepatic bile duct with a presence of an accessory lobe of liver. The gall bladder was contracted with multiple stones. Extrahepatic biliary duct was found normal intraoperatively. A cholecystectomy with resection of the accessory liver lobe was done. Post operatively patient had persistence of jaundice for which a magnetic resonance cholangiopancreatography was done, revealing a distal common bile duct calculus. Patient underwent endoscopic retrograde cholangiopancreatography with stone extraction on post operative day 10 relieving the symptoms. Patient is on regular follow up with no further complications. Awareness of such unusual occurrences is necessary for early diagnosis and instituting the appropriate treatment thereby reducing the mortality.

show abstract

Section: Discussionmentioning

confidence: 99%

A case report of spontaneous biliary peritonitis with accessory liver lobe: rare presentation of a rare pathology

et al. 2021

View full text Add to dashboard Cite

show abstract

“…[10][11][12][13] For adult cases, acute pancreatitis, acalculous cholecystitis, human immunodeficiency virus infection, Hodgkin lymphoma, tuberculosis, and severe necrotizing enterocolitis are considered to be the important pathogenic roles. [14][15][16] Its pathogenesis is still unclear, but there are several possible explanations for spontaneous bile duct perforation: (1) stones, tumors, or inflammatory stricture obstructing the distal bile duct and increasing intraductal pressure 1,[17][18][19] ; (2) biliary stones directly eroding the duct wall 17 ; (3) cholangitis causing the intramural infection of the duct 20 ; (4) biliary vascular insufficiency caused by various factors 20 ; (5) regurgitation of pancreatic and duodenal secretions into the bile duct 21,22 ; (6) bile duct diverticulum 23,24 ; and (7) other factors, including age, nutritional status, diabetes, and so on. Among all of these causative factors, biliary stone is the most frequent cause, especially after choledocholithiasis.…”

Section: Discussionmentioning

confidence: 99%

Biliary Peritonitis Due to Spontaneous Perforation of the Left Intrahepatic Bile Duct in an Adult: A Case Report and Review of Literature

Cai

Pan

et al. 2018

International Surgery

View full text Add to dashboard Cite

Spontaneous perforation of the left intrahepatic bile duct is extremely rare, especially in adults. Here, we report on a case of a 64-year-old woman who had a complaint of right upper abdominal pain for 10 days, which gradually progressed to entire abdominal pain for 3 days, and was admitted to our hospital. Relevant examinations revealed she had a normal cardiac and lung workup, but an obvious abnormal abdominal computed tomography examination, which revealed an enlarged gallbladder, choledocholithiasis with dilatation of the common bile duct (1.8 cm) and intrahepatic bile duct, and a lot of encapsulated ascites. After being given adequate fluid resuscitation and active preoperative preparation, cholecystectomy and common bile duct exploration and perforation repair operation were then performed. The postoperative course was uneventful, and she was discharged with the T-tube in situ. A choledochoscopy examination at week 6 showed the conditions of the intrahepatic and extrahepatic bile duct were good. For these patients, early diagnosis and surgical treatment are essential for good prognosis. The goal of our surgery is to stop bile leakage, resolve choledocholithiasis and cholangitis, and reconstruct the bile duct.

show abstract

“…(i) Increased intraductal pressure by gallstones [3,6,7], mucus plugs [8], tumor [9], parasites [10], acquired or congenital strictures of the biliary tree [11], spasm or disease of the sphincter of Oddi, or alteration of the ampulla of Vater [12,13] (ii) Erosion or necrosis of the bile duct wall due to compression by stones [3] (iii) Infection and thrombosis of intramural vessels with ischemic necrosis in the case of cholangitis [14] or suppuration with abscess formation around the bile duct [15] (iv) Malformations such as diverticula and congenital cystic dilatation [11,16,17] (v) Congenital malfunction of the wall at the junction of the cystic and common hepatic ducts [18], although this has been questioned [6,14] Perforation is also found in patients after biliary surgery as a result of the following:…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Perforation of the Common Bile Duct in an Adult

2012

View full text Add to dashboard Cite

Spontaneous perforation of the bile duct is a rare disease in children and even rarer in adults. Although diagnostic techniques have advanced over the past years, yet most cases are diagnosed at operation. A 44-year-old woman presented with epigastric pain and vomiting of one-day duration. Abdominal distension with tenderness and guarding was present all over the abdomen. Abdominal ultrasonography showed free fluid in the peritoneal cavity with sluggish peristalsis. Abdominal and chest radiographs were normal. At laparotomy, common bile duct CBD was perforated at the junction of CBD and cystic duct. Cholecystectomy with CBD exploration was done and CBD was closed over a T-tube, and external drainage was carried out. The patient recovered well, and on the 12th postoperative day, a T-tube cholangiogram was performed which was normal. The T-tube was removed on the 14th postoperative day. One month after operation, the patient was well. Examining the patient with a suspicious thinking helps in early diagnosis and management of the patient.Keywords Spontaneous . Common bile duct . Perforation CBD perforation is uncommon, usually reported in infants due to congenital anomalies. Cases have been reported in adults following invasive procedures in and around the CBD. But spontaneous perforation of CBD occurring in an adult presenting as acute abdomen is an unusual phenomenon. We report one such case which presented as acute abdomen exploratory. Laparotomy was done and CBD was found perforated. CBD was explored and closed over the T-tube and the patient recovered uneventfully (Fig. 1). CaseA 44-year-old woman presented with epigastric pain and vomiting of one-day duration. On examination, the abdomen was distended. There was tenderness and guarding in the whole abdomen. On ultrasound examination, there was moderate free fluid in the peritoneal cavity with sluggish peristalsis. Plain radiograph abdomen and chest were normal. Investigations of complete hemogram, blood urea, serum creatinine, and serum electrolytes were within normal limits.The patient was resuscitated and explored. There was bile mixed with peritoneal fluid in the peritoneal cavity. Whole of small and large bowel was explored and was found normal. A perforation was found in the common bile duct (CBD) near the junction of cystic duct and CBD. Cholecystectomy was done and the CBD was explored. There was no calculus, stenosis, or any malformation of CBD. The CBD was closed over a T-tube. Peritoneal lavage was given and abdomen was closed with a subhepatic drain. Bile culture showed Escherichia coli and Widal was also within normal limits. Patient's ELISA for HIV was normal. Investigations for Mycobacterium tuberculosis were negative. The patient had a smooth recovery in the post-operative period. AT-tube cholangiogram was performed on the 12th post-operative day, which was normal. The T-tube was removed on the 14th postoperative day. The patient was discharged after removal of the T-tube. DiscussionSpontaneous CBD perforations are more commonly report...

show abstract

Spontaneous perforation of the common hepatic duct

Abstract: A case of spontaneous calculous perforation of the common hepatic duct is presented. The late result of duct repair, that of stricture formation, is illustrated.

Cited by 14 publications

References 7 publications

A case report of spontaneous biliary peritonitis with accessory liver lobe: rare presentation of a rare pathology

A case report of spontaneous biliary peritonitis with accessory liver lobe: rare presentation of a rare pathology

Biliary Peritonitis Due to Spontaneous Perforation of the Left Intrahepatic Bile Duct in an Adult: A Case Report and Review of Literature

Spontaneous Perforation of the Common Bile Duct in an Adult

Contact Info

Product

Resources

About