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KMID : 0378019730160100069
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New Medical Journal
1973 Volume.16 No. 10 p.69 ~ p.73
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Bile Peritonitis due to Spontaneous Perforation of the Common Bile Duct
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Abstract
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Spontaneous perforation of common bile duct is a rare condition which is a rupture of common bile duct without antecedent history of trauma and previous surgery.
The attributable factors include direct pressure of a calculus on the wall of the duct, thrombosis of the mural vessels of the duct with resultant necrosis, increased intraductal pre-ssure due to spasm of shincter of Oddi, infection, digestion due to reflux of pancreatic secretions and diverticulum.
Spontaneous perforation of common bile duct is frequently mis-diagnosed with myocardial infarction, mesenteric thrombosis, peptic ulcer perforation, acute obstructive cholangitis and acute pancreatitis. If the operative intervention is delayed, high mortality is encountered because of bile peritonitis.
The author experienced a case of case of spontaneous perforation of common bile duct due to a large common duct stone. This patient was a full term pregnant woman with labor pain.
At first the author missed correct diagnosis because labor pain and abdominal pain from bile peritonitis were simultaneously complained.
Preoperative patient´s general condition was very poor.
The perforated site of common bile duct was closed by mobilized gallbladde fundusr(cholecystocholedochostomy) because enterostomy was impessible.
The author present a case of spontaneous perforation of common bile duct and review literatures briefly.
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