title: Spontaneous perforation of the right hepatic duct.
abstract: Spontaneous perforation of the biliary ductal system is a rare cause of peritonitis with a high morbidity and mortality rate. We present a case of an 80-year-old female who presented to the Emergency Department with acute onset abdominal pain and peritoneal signs. She was taken to the operating room for exploratory laparotomy and discovered to have a perforation of her right hepatic duct. Several risk factors were found to play a role in her biliary perforation: biliary calculi, infection, and vessel thrombosis. She underwent a cholecystectomy, choledochotomy with removal of gallstones, repair of the perforation, and placement of a T-tube. She had a prolonged recovery in the intensive care unit and was eventually discharged to a skilled nursing facility. We conclude that the management of this unique and highly fatal disease can be applied with an excellent outcome.
authors.affiliation: Department of Surgery, Washington Hospital Center, Room G-253, 110 Irving St., NW, Washington, DC 20010, USA.
authors.forename: W D
authors.initials: WD
authors.lastname: Nguyen
authors.forename: E
authors.initials: E
authors.lastname: Daza
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001653:Bile Ducts, Intrahepatic / Q000293:injuries*; D005260:Female; D006801:Humans; D010538:Peritonitis / Q000209:etiology*; D012422:Rupture, Spontaneous