Idiopathic perforation of the biliary tract in infancy

Stringel, Gustavo; Mercer, Stanley

doi:10.1016/s0022-3468(83)80356-x

Cited by 35 publications

(40 citation statements)

References 12 publications

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“…In cases with distal obstruction of the CBD, a biliary enteric bypass should be considered. If peroperative cholangiogram is not available, then the condition is best managed by closure over a T-tube along with cholecystectomy [12], as done in our case. Simple peritoneal drainage with T-tube is also recommend even if there is a distal obstruction, because exploration of the porta-hepatis may be hazardous at emergency and this entails less morbidity and has a good chance of recovery from the condition or at least stabilizing the patient for second look definitive surgery [10].…”

Section: Discussionmentioning

confidence: 97%

“…Congenital stenosis of ampulla of Vater, congenital malformation of pancreaticobiliary junction, choledocholithiasis, inspissated bile, biliary sludge, protein plugs, obstruction of CBD by tumor, parasites or spasm of spincter of Oddi may lead to raised canalicular pressure and cause perforation [4], [5], [6], [7], [8]. The junction of cystic duct and hepatic duct is the most common site of perforation [2], [9]. Other sites include cystic duct, common hepatic duct and common bile duct.…”

Section: Discussionmentioning

confidence: 99%

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Spontaneous perforation of common bile duct in a young female: An intra-operative surprise

Mohanty

Mahapatra

Behera

et al. 2017

International Journal of Surgery Case Reports

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Spontaneous perforation of common bile duct in a young female: An intra-operative surprise

Mohanty

Mahapatra

Behera

et al. 2017

International Journal of Surgery Case Reports

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“…Since then, there have been less than 160 reported cases in children. Although it is a rare condition, it is described as the second most common surgical cause of jaundice in infancy after biliary atresia [2]. SBP is theorized to occur after insult to a weakened segment of bile duct wall.…”

Section: Discussionmentioning

confidence: 99%

Paediatric infant presenting with an atypical spontaneous biliary perforation

Ofri¹,

Jiwane²

2014

Annals of Pediatric Surgery

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“…The etiological factors that are thought to be the cause of spontaneous CBD perforation in infants are choledochal cysts and anomalous union of the pancreaticobiliary ductal system which results in reflux of pancreatic juices and tissue destruction, distal bile duct stenosis, or atresia leading to congenital weakness of the CBD [1][2][3][4][5].…”

Section: Discussionmentioning

confidence: 99%

“…The commonest reported site of perforation is at the junction of the cystic and hepatic ducts [4,5,24]. Other sites include cystic duct, common hepatic duct, and common bile duct.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Perforation of the Common Bile Duct in an Adult

2012

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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...

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Idiopathic perforation of the biliary tract in infancy

Cited by 35 publications

References 12 publications

Spontaneous perforation of common bile duct in a young female: An intra-operative surprise

Spontaneous perforation of common bile duct in a young female: An intra-operative surprise

Paediatric infant presenting with an atypical spontaneous biliary perforation

Spontaneous Perforation of the Common Bile Duct in an Adult

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