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

Sakamoto, Risa; Kai, Kengo; Hiyoshi, Masahide; Imamura, Naoya; Yano, Koichi; Hamada, Takeomi; Nishida, Takahiro; Kawano, Fumiaki; Sakurahara, Daichi; Uchise, Yukako; Yamamoto, Kōji; Kataoka, Hiroaki; Nanashima, Atsushi

doi:10.1186/s40792-021-01290-9

Cited by 3 publications

(2 citation statements)

References 23 publications

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“…On the other hand, an increase in intraductal pressure due to choledocholithiasis, congenital stenosis of the ampulla of Vater, Oddi's sphincter spasms, or the presence of parasites in the CBD may also play a key role. 9,10 .…”

Section: Discussionmentioning

confidence: 99%

Choledocholithiasis as a Cause of Spontaneous Common Bile Duct Perforation: From Myths to Reality. A Case Report

González,

Gómez,

Ospina

et al. 2024

Preprint

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Introduction: Spontaneous common bile duct (CBD) perforation is a rare complication of choledocholithiasis. Typically, it's diagnosed during surgery, particularly exploratory laparotomy, in patients experiencing acute abdomen. Case description: We present a case of a 16-year-old female with no prior medical history except for a cesarean section two months prior, who presented to the emergency department with abdominal pain. During surgery, we diagnosed spontaneous CBD perforation due to choledocholithiasis and described the treatment. Discussion: Due to its low incidence, diagnosis of spontaneous CBD perforation is often delayed, leading to increased morbidity and mortality. Symptoms vary, and diagnostic imaging is nonspecific. Treatment choice between conservative and surgical approaches depends on patient hemodynamic stability, perforation characteristics, and CBD condition. Surgical options include bile duct repair or reconstruction. Conclusion: Spontaneous CBD perforation is rare and usually diagnosed during surgery. Treatment ranges from conservative measures to bile duct reconstruction.

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Section: Discussionmentioning

confidence: 99%

Choledocholithiasis as a Cause of Spontaneous Common Bile Duct Perforation: From Myths to Reality. A Case Report

González,

Gómez,

Ospina

et al. 2024

Preprint

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“…По 1 наблюдению пришлось на ДВС-синдром [25], тромбоэмболию легочной артерии [32], плеврит [30]. У 1 пациента развился рецидив холедохолитиаза, что потребовало повторной ЭПСТ с литэкстракцией [23], в 1 наблюдении -кровотечение вокруг наружного желчного дренажа, выполнена селективная эндо васкулярная эмболизация [59]. В 1 наблюдении после удаления наружного билиарного дренажа отмечено подтекание желчи из фистулы [27].…”

Section: Abstract: Liver Bile Duct Rupture Spontaneous Perforation He...unclassified

Spontaneous perforation in the bile duct system

Sigua,

Rakita,

Rud

et al. 2023

Ann. hir. gepatol.

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Aim. To evaluate different therapeutic and diagnostic approaches in spontaneous bile duct perforation.Materials and methods. The present study involved the reports on spontaneous perforations in the bile duct system, published from 01.01.2000 to 01.06.2022 and selected by structured search in PubMed/Medline database.Results. As a result, 58 articles describing 71 patients were selected for the study. The most frequent symptoms of the disease included abdominal pain (92.9%), fever (39.4%), and jaundice (33%). The provisional diagnosis was made correctly in 52.1% of cases. The development of the disease was most often associated with choledocholithiasis (38%). Bile ducts perforation of the left hepatic lobe was revealed in 40.6% of cases, perforation of the common bile duct – in 35.5%. Bile duct perforation resulted in peritonitis in 42.2% of patients and bile accumulation or abscess in 30.9%. Encapsulated and intrahepatic accumulation of bile was found in 18.3% of cases. Management of perforations with development of encapsulated and intrahepatic bile accumulation included combined treatment, embracing percutaneous transhepatic drainage and endoscopic methods. Perforation of bile ducts with development of extensive forms of the disease required two-stage treatment. The first stage involved lavage of the abdominal cavity and decompression of the biliary tract. The second stage involved resective and reconstructive surgery to eliminate the cause of the perforation. The mortality rate was 5.6%.Conclusion. Spontaneous perforation in the bile duct system is a rare pathological state appeared as a complication of hepatopancreaticoduodenal diseases. Its management requires greater awareness of abdominal surgeons. The surgical strategy is based on correctly diagnosed and staged treatment tactics, which allows the incidence of complications and mortality rate to be reduced.

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Spontaneous perforation of the common bile duct in adults presenting as biliary peritonitis: a case report and literature review

Bouzid

Fendri

Rejab

et al. 2023

Annals of Medicine &Amp; Surgery

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Introduction: Spontaneous perforation of the common bile duct (SPCBD) is an exceptional disease, especially in adults. The cause is often idiopathic once trauma and choledochal cyst are excluded. Early diagnosis is often difficult because of its often-misleading appearance. Case presentation: The authors report the case of a 54-year-old man, a known case of type 2 diabetes mellitus, who presented to our emergency department for acute abdominal pain that had evolved for 2 days. Clinical findings and investigations: On physical examination, the patient had a fever of up to 38.5°C, and the abdomen was distended and generally tight. The abdominal computerized tomography scan confirms the presence of free fluid. In addition, the thickness of the gallbladder wall had increased in contrast with a resolved gallbladder distention. Because exploration failed to demonstrate the cause of ascites, the authors performed a diagnostic paracentesis, which revealing ascites with a dark yellow-green color, which implied bile leakage. After initial resuscitation, an emergent exploratory laparotomy was performed. The authors found biliary peritonitis secondary to SPCBD. After peritoneal lavage, the perforation was repaired over a T-tube. The postoperative course was uneventful. Histological findings were consistent with ulcerous acalculous cholecystitis. The patient was disease-free after a 3-month follow-up. Discussion: SPCBD is an uncommon condition in adults, and it is rarely reported in the literature. The pathogenesis of this disease is not clear and may be related to single or multiple factors. Usually, this disease is diagnosed in the postmortem. Early diagnosis and optimal surgical treatment are challenging. Conclusion: This present case highlighted the preoperative diagnostic difficulties of the SPCBD. Emergent surgical management should be instituted in the shortest time possible to reduce the high mortality.

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

Cited by 3 publications

References 23 publications

Choledocholithiasis as a Cause of Spontaneous Common Bile Duct Perforation: From Myths to Reality. A Case Report

Choledocholithiasis as a Cause of Spontaneous Common Bile Duct Perforation: From Myths to Reality. A Case Report

Spontaneous perforation in the bile duct system

Spontaneous perforation of the common bile duct in adults presenting as biliary peritonitis: a case report and literature review

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