Spontaneous Perforation of the Bile Duct
10.13029/jkaps.1996.2.2.143
- Author:
Sao Young YOO
1
;
Yong Tae PARK
;
Seung Hoon CHOI
;
Eui Ho HWANG
Author Information
1. Division of Pediatric Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Bile duct perforation;
Spontaneous
- MeSH:
Abdominal Pain;
Appendicitis;
Ascites;
Bile Ducts;
Bile;
Child;
Cholangiography;
Cholangiopancreatography, Endoscopic Retrograde;
Cholecystectomy;
Common Bile Duct;
Dilatation;
Drainage;
Female;
Fever;
Follow-Up Studies;
Hepatic Duct, Common;
Hepatitis;
Humans;
Laparotomy;
Liver;
Peritoneal Cavity;
Ultrasonography
- From:Journal of the Korean Association of Pediatric Surgeons
1996;2(2):143-147
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Spontaneous perforation of the bile duct in children is a very rare disorder. We experienced a 6 year-old girl with spontaneous perforation of the right hepatic duct. The patient was initially misdiagnosed as hepatitis because of elevation of liver enzyme and then as appendicitis because of fluid collection in the pelvic cavity demonstrated by ultrasonogram. A laparoscopic exploration was done and no abnormal findings were detected except bile-stained ascites. Peritoneal drainage was performed and the patients seemed to improve clinically. Abdominal pain, distention and high fever developed after removal of the drains. DISIDA scan showed a possible of bile leak into the peritoneal cavity. ERCP demonstrated free spiil of dye from the right hepatic duct. At laparotomy, the leak was seen in the anterior wall of the right hepatic duct 2cm above the junction of the cystk duct and common hepatic duct. The perforation was linear in shape and 0.8cm in size. The patient underwent cholecystectomy, primary closure of the perforation and T-tube choedochostomy. We could not identify the cause of the perforation; however, the T-tube cholangiography taken on the 42nd postoperative day showed a little more dilatation of the proximal common bile duct compared with the cholangiography taken on the 14th day. Long-term follow-up of the patient will be necessary because of the possibility for further change of the duct.
