Spontaneous rupture of the common hepatic duct associated with acute pancreatitis: a case report

J Med Case Rep. 2017 Jun 21;11(1):165. doi: 10.1186/s13256-017-1283-6.

Abstract

Background: Rupture of the common bile duct is a life-threatening condition, usually observed after a trauma or in association with choledocholithiasis or an obstructive tumor of the bile duct. However, a spontaneous rupture of the common bile duct is a rare entity.

Case presentation: We report a new observation of a spontaneous rupture of the common bile duct, associated with biliary peritonitis and pancreatitis, in a 15-year-old North African girl. Etiological aspects, specificities of clinical presentation, means of diagnosis, as well as surgical and perioperative management are discussed.

Conclusions: The diagnosis of spontaneous rupture of the common bile duct is a challenge for both radiologist and surgeon. Beyond the difficulty of diagnosis, which requires radiological exploration, management of the subsequent biliary peritonitis involves urgent surgery, life-supporting measures, and close monitoring.

Keywords: Cholangiography; Common bile duct; Computed tomography; Pancreatitis; Peritonitis; Spontaneous rupture.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain
  • Acute Disease
  • Adolescent
  • Anti-Bacterial Agents / therapeutic use
  • Bile Duct Diseases / diagnostic imaging
  • Bile Duct Diseases / etiology*
  • Bile Duct Diseases / pathology*
  • Bile Duct Diseases / surgery
  • Cholangiography
  • Cholecystectomy
  • Female
  • Fever
  • Hepatic Duct, Common / diagnostic imaging
  • Hepatic Duct, Common / pathology*
  • Hepatic Duct, Common / surgery
  • Humans
  • Pancreatitis / complications*
  • Pancreatitis / diagnostic imaging
  • Pancreatitis / therapy
  • Peritoneal Lavage
  • Peritonitis / diagnostic imaging
  • Peritonitis / etiology
  • Peritonitis / therapy
  • Rupture, Spontaneous / diagnostic imaging
  • Rupture, Spontaneous / etiology*
  • Rupture, Spontaneous / pathology*
  • Rupture, Spontaneous / surgery
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents