Gallstone-Induced Perforation of the Common Bile Duct in Pregnancy

Dabbas, Natalie; Abdelaziz, Mohamed; Hamdan, Khaled; Stedman, Brian; Hilal, Mohammed Abu

doi:10.1155/2008/174202

Cited by 14 publications

(8 citation statements)

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“… [ 11 ] Goodlin et al 1991 ? 4 Gall bladder Gangrene of Gall bladder Postpartum Cholecystectomy [ 12 ] Petrozza et al 1995 28 G7P6 23 G4P4 2 Gall bladder Gall stone Postpartum Cholecystectomy [ 13 ] McGrath et al 2005 34 G1P0 1 CBD Gall stone Postpartum Sphincterotomy + Stent placement [ 14 ] Talwar et al 2006 28 G2P1 1 Gall bladder Gall stone During pregnancy Cholecystectomy [ 15 ] Talwar et al 2006 21 G1P0 1 CBD Idiopathic During pregnancy Over T-tube repair [ 15 ] Dabbas et al 2008 20 G1P1 1 CBD Gall stone Postpartum Choledocholithotomy + Over T-Tube repair [ 16 ] Bediako-Bowan et al 2013 29 ? 1 CBD Idiopathic …”

Section: Discussionmentioning

confidence: 99%

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

Masroor

Sarwari

2021

BMC Surg

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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.

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Section: Discussionmentioning

confidence: 99%

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

Masroor

Sarwari

2021

BMC Surg

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“…In these cases, the authors reported that the loss of bile duct wall continuity on CT and high bilirubin levels in ascites were important diagnostic factors [ 4 , 16 , 23 , 24 ]. Although most of the other cases were diagnosed by exploratory laparotomy, the perforation site in some cases could not be identified intraoperatively and required subsequent re-operation [ 5 ] or endoscopic retrograde cholangiopancreatography [ 3 ] for diagnosis. Notably, in a few cases, the perforation site could not be identified intraoperatively despite bile duct perforation being suspected preoperatively [ 1 , 3 ].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous common bile duct perforation due to choledocolithiasis accompanied with pancreaticobiliary maljunction in an adult: a case report

et al. 2021

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Background Spontaneous common bile duct (CBD) perforation is an extremely rare disease in adults. We report an adult case of CBD perforation due to choledocolithiasis accompanied with pancreaticobiliary maljunction, which is, to our knowledge, the first such case report based on a search using PubMed. Case presentation A 71-year-old woman with consciousness disorder was transported to the emergency department of another hospital. She was diagnosed as having severe peritonitis with septic shock and transferred to our hospital for emergency surgery. Enhanced computed tomography (CT) revealed supraduodenal CBD dilation similar to a diverticulum and a defect of bile duct wall continuity. Furthermore, CT showed a long common channel of the pancreaticobiliary duct, so she was diagnosed as having spontaneous CBD perforation with pancreaticobiliary maljunction. Emergency surgery was performed that revealed a necrotic diverticulum-like change on the supraduodenal part, and a 2.5 × 1 cm perforation was found on the anterolateral wall of the CBD. Peritoneal lavage was performed, and CBD perforation was resolved with a T-tube. The patient suffered refractory intra-abdominal and retroperitoneal abscess formation and bleeding from the abdominal wall, which required a long period of postoperative management. The T-tube was removed on day 136, and the patient was transferred on day 153. Conclusion The cause of CBD perforation is commonly considered to be increased intraductal pressure or weakness of the bile duct wall. In this case, pancreaticobiliary maljunction may have significantly influenced onset and the postoperative course. This case suggests that early surgical intervention and appropriate drainage are important to ensure survival.

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“…The most common site of extrahepatic bile duct perforation (excluding the gallbladder which complicates up to 10% cases of acute cholecystitis [ 2 ]) is the CBD (42 patients) followed by the common hepatic duct (28 patients) [ [6] , [11] ]. In one case series, nine of the 11 patients had intrahepatic ductal perforation [ 6 ].…”

Section: Discussionmentioning

confidence: 99%