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

Abstract EN

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.