title: [A case of spontaneous perforation of the common bile duct associated with cholangitis].
abstract: Spontaneous perforation of the common bile duct (CBD) is a rare event in adults. Most cases of CBD perforation are iatrogenic after invasive procedures such as endoscopic retrograde cholangiopancreatography (ERCP) or cholecystectomy. We report a case of an 81-year-old woman who presented with severe right upper abdominal pain, fever, and chills. Abdominal CT showed multiple gallbladder and CBD stones and loculated fluid collection in the inferoposterior portion of the stomach. ERCP showed the leakage of contrast media into the peritoneal cavity from the CBD. We performed endoscopic sphincterotomy (EST) and endoscopic nasobiliary drainage (ENBD) to decompress the CBD instead of emergent surgical intervention. One week later, cholangiography via ENBD tube revealed that there was no more leakage of the contrast media from the CBD. We performed cholecystectomy, removal of the CBD stones after exploration of the CBD, and T tube insertion. The perforated site of the CBD was closed and there was no more fluid collection in the inferoposterior portion of the stomach. Medical treatment including endoscopic procedures was useful for healing of the perforated CBD.
authors.affiliation: Department of Internal Medicine, Hallym University College of Medicine, Anyang, Korea.
authors.forename: Byoung Kwan
authors.initials: BK
authors.lastname: Yoo
authors.forename: Jong Hyeok
authors.initials: JH
authors.lastname: Kim
authors.forename: Hong Ju
authors.initials: HJ
authors.lastname: Moon
authors.forename: Won Seok
authors.initials: WS
authors.lastname: Cheon
authors.forename: Ji Youn
authors.initials: JY
authors.lastname: Yoo
authors.forename: Jong Pyo
authors.initials: JP
authors.lastname: Kim
authors.forename: Kyoung Oh
authors.initials: KO
authors.lastname: Kim
authors.forename: Cheol Hee
authors.initials: CH
authors.lastname: Park
authors.forename: Tae Ho
authors.initials: TH
authors.lastname: Hahn
authors.forename: Kyo Sang
authors.initials: KS
authors.lastname: Yoo
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Park
authors.forename: In Jae
authors.initials: IJ
authors.lastname: Lee
authors.forename: Choong Kee
authors.initials: CK
authors.lastname: Park
mesh_terms: D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002761:Cholangitis / Q000150:complications*; D042883:Choledocholithiasis; D003137:Common Bile Duct Diseases / Q000209:etiology*; D005260:Female; D006801:Humans; D012422:Rupture, Spontaneous