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

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

Makram Moussa  1   2 , Wissem Triki  3   4 , Omar Karray  3   4 , Ines Marzouk  4   5 , Bouchoucha Sami  3   4
Affiliations
Case Reports

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

Makram Moussa et al. J Med Case Rep. .

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.

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Figures

Fig. 1
Fig. 1
Axial computed tomography showing a dilation of the main bile duct (arrow) and a peritoneal fluid effusion (asterisk)
Fig. 2
Fig. 2
Intraoperative view showing the common hepatic duct perforation (arrow)
Fig. 3
Fig. 3
Postoperative cholangiography
Fig. 4
Fig. 4
Magnetic resonance cholangiopancreatography performed 6 months after surgery showing a moderate biliary dilation among a stricture (arrow)
See this image and copyright information in PMC

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