Spontaneous common bile duct perforation due to chronic pancreatitis, presenting as a huge cystic retroperitoneal mass: a case report

Abstract

Spontaneous perforation of the bile duct, is a disease in which spontaneous perforation occurs in the wall of the extrahepatic or intrahepatic duct without any traumatic or iatrogenic injury and more often described in neonates. In this report, we present a 38-year-old female patient who underwent surgery due to an intraabdominal cystic mass. The diagnosis of spontaneous rupture of the common bile duct and huge retroperitoneal biloma was made by intraoperative abdominal exploration. The biloma was drained, ruptured portion of the common bile duct was primarily repaired over a T-tube.

Figure 1.

(A and B) Abdominal CT scan of the patient (A, B): (A) Complex cystic retroperitoneal mass 20 cm in diameter, extending from liver to pelvis; (B) Dilatation of the intra and extrahepatic bile ducts, atrophy and parenchymal calsifications of the pancreas and dilatation of the Wirsung’s duct.

Figure 2.

Peroperative Cholangiography of the patient: A stenosis of the distal common bile duct with well-arranged margins and regular thinning, revealing chronic pancreatitis.