title: Spontaneous Perforation of Common Bile Duct: A Rare Presentation of Gall Stones Disease.
abstract: Background. Spontaneous perforation of the extrahepatic biliary system is a rare presentation of gall stones. Very few cases of bile duct perforation have been reported in adults. It is rarely suspected or correctly diagnosed preoperatively. Case Presentation. A 66-year-old female presented at the surgical emergency with 3 days' history of severe upper abdominal pain with distension and repeated episodes of vomiting, as she had evidence of generalized peritonitis and underwent an exploratory laparotomy. A single 0.5 cm × 0.5 cm free perforation was present on the anterolateral surface of the common bile duct at the junction of cystic duct. A cholecystectomy and the CBD exploration were performed. Conclusion. Spontaneous perforation of the extrahepatic bile duct is a rare but important presentation of gall stones in adults. Therefore, awareness of the clinical presentation, expert ultrasound examination, and surgery are important aspects in the management.
authors.affiliation: Department of General Surgery, General Hospital, 60000 Kurunegala, Sri Lanka.
authors.forename: Duminda
authors.identifier: 0000-0002-7342-0220
authors.initials: D
authors.lastname: Subasinghe
authors.affiliation: Department of General Surgery, General Hospital, 60000 Kurunegala, Sri Lanka.
authors.forename: Edippuli Arachchige Don
authors.initials: EA
authors.lastname: Udayakumara
authors.affiliation: Department of General Surgery, General Hospital, 60000 Kurunegala, Sri Lanka.
authors.forename: Upul
authors.initials: U
authors.lastname: Somathilaka
authors.affiliation: Department of General Surgery, General Hospital, 60000 Kurunegala, Sri Lanka.
authors.forename: Milinda
authors.initials: M
authors.lastname: Huruggamuwa