scholarly journals Spontaneous Perforation of Common Bile Duct: A Rare Presentation of Gall Stones Disease

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Duminda Subasinghe ◽  
Edippuli Arachchige Don Udayakumara ◽  
Upul Somathilaka ◽  
Milinda Huruggamuwa
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Extrahepatic Bile Duct ◽  
Exploratory Laparotomy ◽  
Spontaneous Perforation ◽  
Rare Presentation ◽  
Free Perforation ◽  
Generalized Peritonitis ◽  
Gall Stones ◽  
Upper Abdominal

Background. Spontaneous perforation of the extrahepatic biliary system is a rare presentation of gall stones. Very few cases of bile duct perforation have been reported in adults. It is rarely suspected or correctly diagnosed preoperatively.Case Presentation. A 66-year-old female presented at the surgical emergency with 3 days’ history of severe upper abdominal pain with distension and repeated episodes of vomiting, as she had evidence of generalized peritonitis and underwent an exploratory laparotomy. A single 0.5 cm×0.5 cm free perforation was present on the anterolateral surface of the common bile duct at the junction of cystic duct. A cholecystectomy and the CBD exploration were performed.Conclusion. Spontaneous perforation of the extrahepatic bile duct is a rare but important presentation of gall stones in adults. Therefore, awareness of the clinical presentation, expert ultrasound examination, and surgery are important aspects in the management.

scholarly journals Spontaneous common bile duct perforation in full term pregnancy: a rare case report and review of literature

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Matiullah Masroor ◽  
Mohammad Arif Sarwari
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Exploratory Laparotomy ◽  
Interesting Case ◽  
High Morbidity ◽  
Rare Presentation ◽  
Diffuse Abdominal Pain ◽  
Generalized Peritonitis ◽  
Rare Case Report ◽  
The Common

Abstract Background Spontaneous biliary system perforation is a rare presentation in clinical practice especially in adults. It is rarely suspected and diagnosed preoperatively due to small number of cases, vague sign and symptoms, and ambiguous presentation. Case presentation We describe an interesting case of spontaneous perforation of the common bile duct in a 16 year-old female who presented a week after her first birth to the emergency department with complaints of diffuse abdominal pain, abdominal distention, fever, vomiting, and constipation. She was having generalized peritonitis but the etiology was unclear despite a thorough workup. She underwent exploratory laparotomy, and a perforation in the supra duodenal region of the common bile duct was found intraoperatively. The common bile duct was repaired over T-tube, and cholecystectomy was performed; the patient was recovered uneventfully. Conclusion Spontaneous biliary perforation is a rare cause of acute abdomen in adults and extremely rare in pregnancy. Its delayed diagnoses and management can lead to a high morbidity and mortality. All physicians, especially surgeons, should be aware of this possibility and consider it a cause of peritonitis on differential diagnosis particularly when there is no apparent etiology available for presentation.

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

2018 ◽  
Vol 103 (7-8) ◽  
pp. 339-343
Author(s):  
Wenwu Cai ◽  
Ke Pan ◽  
Qinglong Li ◽  
Xiongying Miao ◽  
Chang Shu
Keyword(s):  
Abdominal Pain ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Extrahepatic Bile Duct ◽  
Intrahepatic Bile Duct ◽  
Bile Leakage ◽  
Common Bile Duct Exploration ◽  
Good Prognosis ◽  
Spontaneous Perforation ◽  
Repair Operation

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.

scholarly journals Spontaneous Common Bile Duct Perforation in Full Term Pregnancy: A Rare Case Report and Review of Literature

2020 ◽  
Author(s):  
Matiullah Masroor ◽  
Mohammad Arif Sarwari
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Adult Population ◽  
Exploratory Laparotomy ◽  
Interesting Case ◽  
High Morbidity ◽  
Rare Presentation ◽  
Generalize Peritonitis ◽  
Diffuse Abdominal Pain ◽  
Rare Case Report

Abstract Background: Spontaneous biliary system perforation is a rare presentation in clinical practice. It is even rare in adult population than infants. The condition is rarely suspected and diagnosed preoperatively because of small number of cases, vague sign and symptoms and ambiguous presentation.Case presentation: we are presenting an interesting case of spontaneous perforation of common bile duct in a 16 years old lady presented a week after her first delivery to the emergency department with complain of diffuse abdominal pain, abdominal distention, fever, vomiting and constipation. She was having generalize peritonitis but the cause of peritonitis was unknown despite of all available investigations performed. She underwent exploratory laparotomy and a perforation in the supra duodenal region of common bile duct was found intraoperatively. Common bile duct repair over T-tube and cholecystectomy performed and patient recovered.Conclusion: Spontaneous biliary perforation is a rare cause of acute abdomen in adults and extremely rare in pregnancy and its belated diagnoses and management is leading to high morbidity and mortality. All physicians especially surgeons should be aware of its possibility and consider it a cause of peritonitis on differential diagnosis especially when there is no apparent etiology available for the presentation.

scholarly journals Neurofibroma of the bile duct: a rare cause of obstructive jaundice

2013 ◽  
Vol 95 (2) ◽  
pp. e14-e16 ◽  
Author(s):  
A De Rosa ◽  
D Gomez ◽  
AM Zaitoun ◽  
IC Cameron
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Obstructive Jaundice ◽  
Frozen Section ◽  
Extrahepatic Bile Duct ◽  
Benign Lesion ◽  
Exploratory Laparotomy ◽  
Radiological Features ◽  
The Common ◽  
Duct Stricture

Neurofibromas of the common bile duct are extremely rare. The lack of specific clinical or radiological features makes preoperative diagnosis in the absence of histology difficult. We report the case of a female patient who presented with obstructive jaundice and evidence of a common bile duct stricture on imaging. She underwent an exploratory laparotomy, and intraoperative frozen section confirmed clear margins and a benign lesion. Excision of the extrahepatic bile duct and A Roux-en-Y hepaticojejunostomy was performed. We discuss the clinical features and management of neurofibromas of the bile duct in light of the literature.

scholarly journals Spontaneous non-traumatic common bile duct perforation presented as an acute abdomen: a rare case report

2020 ◽  
Vol 7 (8) ◽  
pp. 2773
Author(s):  
Sneha Angadi ◽  
Vinod Biradar
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Acute Abdomen ◽  
Biliary Tract ◽  
Extrahepatic Bile Duct ◽  
Biliary Tree ◽  
Conservative Surgery ◽  
Spontaneous Perforation ◽  
T Tube

The spontaneous perforation of the biliary tract (SPBT) is an extremely rare cause of peritonitis, which was first described by Freeland in 1882, to date only around 70 cases have been reported. Here we present a case of spontaneous perforation of the biliary tract, in a patient with choledocholithiasis. A 45 years old male presented to us with acute abdomen with raised amylase and lipase s/o pancreatitis, imaging showed acute on chronic pancreatitis with impacted distal lumen in situ common bile duct (CBD) calculi. Patient was planned for ERCP with CBD clearance after his acute episode subsides. Meanwhile patient developed rigidity, guarding and distension. His second CECT showed a breach in the lower lateral segment in the CBD with gross ascites. Patient was planned for laparotomy, abdominal lavage and T-tube drainage. Patient had a stormy postoperative course. Patient recovered well and was discharged with T-tube clamped and subhepatic drain in situ. Spontaneous perforation of the extrahepatic bile duct is a rare but important presentation of gall stones. Conservative surgery that is decompression of the biliary tree and repair of the leak site over T-tube is the mainstay of treatment in the acute presentation.

scholarly journals A Resected Case of Mucinous Adenocarcinoma of the Duodenum, Mimicking Intraductal Papillary Neoplasm of the Bile Duct

2015 ◽  
Vol 100 (11-12) ◽  
pp. 1443-1448
Author(s):  
Norio Kubo ◽  
Hideki Suzuki ◽  
Norihiro Ishii ◽  
Mariko Tsukagoshi ◽  
Akira Watanabe ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Transverse Colon ◽  
Extrahepatic Bile Duct ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Mucinous Carcinoma ◽  
Villous Tumor ◽  
Intraductal Papillary Neoplasm ◽  
The Common ◽  
Papillary Neoplasm

Duodenum mucinous carcinoma is very rare, and the prognosis of the patient is very bad, especially when the tumor is invasive to other organs. In this case, duodenum carcinoma was invasive to common bile duct and transverse colon. Mucinous fluid, which was secreted from a duodenum tumor, was found in the dilatated bile duct. The intraductal papillary neoplasm of the bile duct was considered a differential diagnosis. We performed aggressive resection and had a good prognosis. A 74-year-old woman received a diagnosis of cholangitis and was treated with antibiotic drugs. Endoscopic retrograde cholangiopancreatography revealed a defect in the lower common bile duct with the mucoid fluid. We suspected intraductal papillary neoplasm of the bile duct, but no malignant cells were detected. One year later, gastrointestinal fiberscopy revealed a villous tumor in the postbulbar portion of the duodenum; adenocarcinoma was detected in biopsy specimens. Computed tomography revealed dilatation of the duodenum with an enhanced tumor, and dilatation of both the common and intrahepatic bile ducts. Magnetic resonance cholangiopancreatography revealed that the duodenum was connected with the common bile duct and ascending colon. We resected the segmental duodenum, extrahepatic bile duct, left lobe of liver, a partial of the transverse colon, and associated lymph nodes. Although the advanced duodenal carcinoma had poor prognosis, the patient was alive, without recurrence, 5 years after the operation.

scholarly journals Refractory peritonitis by spontaneous perforation of the common bile duct in a patient receiving peritoneal dialysis

2017 ◽  
Vol 3 (1) ◽  
Author(s):  
Manabu Hayata ◽  
Junji Yamashita ◽  
Kentaro Tokunaga ◽  
Masashi Ejima ◽  
Katsuyuki Sagishima ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Spontaneous Perforation ◽  
The Common ◽  
Refractory Peritonitis

Laparoscopic common bile duct exploration in patients with previous upper abdominal surgery

2018 ◽  
Vol 32 (12) ◽  
pp. 4893-4899 ◽  
Author(s):  
Jisheng Zhu ◽  
Gen Sun ◽  
Le Hong ◽  
Xiaohua Li ◽  
Yong Li ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Abdominal Surgery ◽  
Common Bile Duct Exploration ◽  
Upper Abdominal Surgery ◽  
Upper Abdominal

scholarly journals When It Doesn't Fit: Congenital Anomalies of the Choledochus

2020 ◽  
Vol 08 (01) ◽  
pp. e86-e89
Author(s):  
Helena Reusens ◽  
Mark Davenport
Keyword(s):  
Case Report ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Extrahepatic Bile Duct ◽  
Hepatic Duct ◽  
Common Hepatic Duct ◽  
Resected Specimen ◽  
Cystic Dilatation ◽  
Left Hepatic Duct ◽  
Distal Common Bile Duct

Abstract Introduction Congenital choledochal malformations (CCMs) are characterized by intra- and/or extrahepatic bile duct dilatation. Five basic types (1–5) are recognized in Todani's classification and its modifications, of which types 1 and 4 typically have an associated anomalous pancreatobiliary junction and common channel (CC). We describe two cases with previously undescribed features. Case Report 1 Antenatal detection of a cyst at porta hepatis was made in an otherwise normal girl of Iranian parentage. She was confirmed to be a CCM (20 mm diameter), postnatally, with no evidence of obstruction. Surgical exploration was performed at 12 weeks. She had an isolated cystic dilatation of the right-hepatic duct only. The left-hepatic duct and common bile duct (CBD) were normal without a CC. Histology of the resected specimen showed stratified squamous epithelium. Case Report 2 A preterm (31 weeks of gestation) boy of Nigerian parentage was presented. His mother was HIV + ve and he was treated with nucleoside reverse transcriptase inhibitors following birth. He had persistent cholestatic jaundice and a dilated (10 mm) bile duct from birth. Although the jaundice resolved, the dilatation persisted and increased, coming to surgery aged 2.5 years. This showed cystic dilatation confined to the common hepatic duct, and otherwise normal distal common bile duct and no CC. Result Both underwent resection with the Roux-en-Y hepaticojejunostomy reconstruction to the transected right-hepatic duct alone in case 1, leaving the preserved left duct and CBD in continuity, and to the transected common hepatic duct in case 2. Conclusions Neither choledochal anomaly fitted into the usual choledochal classification and case 1 appears unique in the literature.

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