Spontaneous extrahepatic biliary tree perforation

  • Tharuneshan Pillay University of Kwazulu-Natal
  • Vikesh Ramkelawon Lenmed Ethekwini Hospital and Heart Centre
  • Bugsy Singh University of Kwazulu-Natal
Keywords: Common bile duct perforation, Spontaneous, biliary peritonitis

Abstract

Spontaneous perforation of the common bile duct is an extremely uncommon cause of an abdominal emergency. Owing to the rarity of the condition it is seldom suspected or diagnosed preoperatively. We report a case of a 42-year-old female presenting with features of severe biliary pancreatitis who responded well to organ support. Five days post admission she was deemed fit for cholecystectomy to prevent further attacks of pancreatitis. Surgery revealed a common hepatic duct perforation treated with cholecystectomy, lavage and common hepatic duct drainage. This was followed by postoperative biliary stenting which led to complete resolution without further surgery. This conservative staged approach obviated the need for major biliary reconstruction and is a viable strategy when confronted with this rare complication without prior ductal imaging.

Author Biographies

Tharuneshan Pillay, University of Kwazulu-Natal

Department of General Surgery, Nelson R Mandela School of Medicine, University of KwaZulu-Natal

Vikesh Ramkelawon, Lenmed Ethekwini Hospital and Heart Centre

Lenmed Ethekwini Hospital and Heart Centre, Durban

Bugsy Singh, University of Kwazulu-Natal

Department of General Surgery, Nelson R Mandela School of Medicine, University of KwaZulu-Natal

Published
2019-03-29
How to Cite
Pillay, T., Ramkelawon, V., & Singh, B. (2019). Spontaneous extrahepatic biliary tree perforation. South African Journal of Surgery, 57(1), 56. Retrieved from http://sajs.redbricklibrary.com/index.php/sajs/article/view/2770
Section
Case Reports