Acute Abdomen Secondary to a Spontaneous Perforation of the Biliary Tract, a Rare Complication of Choledocholithiasis.

Autor:	Gómez-Torres GA; Department of General Surgery, Hospital Civil de Guadalajara 'Dr. Juan I. Menchaca', Mexico. Electronic address: Gustavo_angel57@hotmail.com., Rodríguez-Navarro FM; Department of General Surgery, Hospital Civil de Guadalajara 'Dr. Juan I. Menchaca', Mexico., López-Lizárraga CR; Department of General Surgery, Hospital Civil de Guadalajara 'Dr. Juan I. Menchaca', Mexico., Bautista-López CA; Department of General Surgery, Hospital Civil de Guadalajara 'Dr. Juan I. Menchaca', Mexico., Ortega-García OS; Department of General Surgery, Hospital Civil de Guadalajara 'Dr. Juan I. Menchaca', Mexico., Becerra-Navarro G; Department of General Surgery, Hospital Civil de Guadalajara 'Dr. Juan I. Menchaca', Mexico., Águila-Barragán A; Department of General Surgery, Hospital Civil de Guadalajara 'Dr. Juan I. Menchaca', Mexico., Ploneda-Valencia CF; Department of General Surgery, Hospital Civil de Guadalajara 'Dr. Juan I. Menchaca', Mexico.
Jazyk:	angličtina
Zdroj:	International journal of surgery case reports [Int J Surg Case Rep] 2017; Vol. 41, pp. 255-258. Date of Electronic Publication: 2017 Oct 27.
DOI:	10.1016/j.ijscr.2017.10.040
Abstrakt:	Introduction: The spontaneous perforation of the biliary tract (SPBT) is an extremely rare cause of peritonitis, which was first described by Freeland in 1982, to date only around 70 cases have been reported. Here we present a case of spontaneous perforation of the biliary tract, in a patient with choledocholithiasis, which was treated with ultrasound-guided drainage and ERCP. Case Report: A 51-year-old male was admitted to the emergency room for 15-day evolution jaundice, localized pain in the right flank and hypochondrium of 3days. He had a history of cholecystectomy 15 years ago and 4 episodes of cholangitis, the last one in 2015. A magnetic resonance imaging (MRI) was performed, that showed evidence of choledocholithiasis, in addition to a possible biliary leakage. The patient was treated with ultrasound-guided drainage and ERCP successfully. Discussion: Spontaneous perforation of the biliary tract is a disease entity in which wall of the extrahepatic or intrahepatic duct is perforated without any traumatic or iatrogenic injury. The clinical presentation varies from nonspecific abdominal pain to biliary peritonitis, in most of the cases forming bilomas. Universal management involves decompression of the biliary tree and repair of the leak site. Conclusion: The spontaneous perforation of the biliary tract is a disease that represents a diagnostic challenge. The treatment in the patients with SPBT is not well established and has to be individualized for each case, depending on the history of the patient, the site of perforation, the time of evolution, the suspicion of infection, and the patient status. (Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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