title: Spontaneous biliary tract perforations: an unusual cause of peritonitis in pregnancy. Report of two cases and review of literature.
abstract: Spontaneous perforations of the biliary tract are rare in adults and even more so during pregnancy. Perforation of the gall bladder is a potentially fatal complication of cholecystitis. The infrequency of perforation in the setting of calculous disease of the gall bladder is probably due to the thickened wall of the organ that has long been the seat of chronic inflammation. Common bile duct perforations have been reported in adults most commonly in association with choledocholithiasis. The diagnosis of biliary tract perforations is often delayed due to their non specific symptoms, which results in high morbidity. Early diagnosis and aggressive therapy are mandatory to alleviate this condition. Delayed diagnoses and treatment may have more serious consequences for pregnant women than for other patients. Very few cases of biliary tract perforations have been reported in pregnant women. We report two such cases in pregnancy: first of a gall bladder perforation associated with cholelithiasis and the second of a common bile duct perforation in pregnancy in which no apparent cause was found.
authors.affiliation: Department of Surgery, Lady Hardinge Medical College, University of Delhi, New Delhi-110001, India. nikhil_talwar@rediffmail.com
authors.forename: Nikhil
authors.initials: N
authors.lastname: Talwar
authors.forename: Manoj
authors.initials: M
authors.lastname: Andley
authors.forename: Bina
authors.initials: B
authors.lastname: Ravi
authors.forename: Ajay
authors.initials: A
authors.lastname: Kumar