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Retroperitoneal Biloma due to Spontaneous Perforation of the Left Hepatic Duct

Patient: Male, 82 Final Diagnosis: Retroperitoneal biloma due to spontaneous perforation of the left hepatic duct Symptoms: Abdominal pain • high fever Medication: — Clinical Procedure: Emergent operation Specialty: Gastroenterology and Hepatology OBJECTIVE: Rare disease BACKGROUND: Spontaneous perf...

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Autores principales: Ishii, Kenjiro, Matsuo, Kazuhiro, Seki, Hiroaki, Yasui, Nobutaka, Sakata, Michio, Shimada, Akihiko, Matsumoto, Hidetoshi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4839257/
https://www.ncbi.nlm.nih.gov/pubmed/27094183
http://dx.doi.org/10.12659/AJCR.897612
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author Ishii, Kenjiro
Matsuo, Kazuhiro
Seki, Hiroaki
Yasui, Nobutaka
Sakata, Michio
Shimada, Akihiko
Matsumoto, Hidetoshi
author_facet Ishii, Kenjiro
Matsuo, Kazuhiro
Seki, Hiroaki
Yasui, Nobutaka
Sakata, Michio
Shimada, Akihiko
Matsumoto, Hidetoshi
author_sort Ishii, Kenjiro
collection PubMed
description Patient: Male, 82 Final Diagnosis: Retroperitoneal biloma due to spontaneous perforation of the left hepatic duct Symptoms: Abdominal pain • high fever Medication: — Clinical Procedure: Emergent operation Specialty: Gastroenterology and Hepatology OBJECTIVE: Rare disease BACKGROUND: Spontaneous perforation of the bile duct in adults is very rare, particularly in cases accompanied by retroperitoneal biloma. We report a patient with retroperitoneal biloma due to a spontaneous perforation of the left hepatic duct. CASE REPORT: An 82-year-old man was admitted to our institution with abdominal pain and a high fever. He had tenderness at the epi-mesogastrium. Computed tomography showed several stones in the gall bladder and common bile duct (CBD) and a few ascites. A substantial amount of fluid had collected from the dorsal stratum of the duodenum and pancreas head to the right paracolic gutter and anterior side of the right iliopsoas. Laboratory examination revealed a high inflammation score. He underwent emergent laparotomy. Biliary fluid was revealed after the mobilization of the pancreas head, duodenum, and right side of the colon. Bile duct perforation was suspected. Therefore, we exfoliated the dorsal side of the CBD to the cranial side, and intraoperative cholangiography was performed. However, the perforation site could not be detected. Cholecystectomy and choledocholithotomy were performed. A retrograde transhepatic biliary drainage tube was inserted, and primary closure of the CBD incision site was achieved. Postoperative cholangiography revealed leakage from the left hepatic duct near the caudate branch. CONCLUSIONS: There are a few reports of spontaneous bile duct perforation cases in the literature, particularly on infants or children with congenital anomalies, but it is rare in adults. It usually causes bile peritonitis, although bile duct perforation should be considered in the differential diagnosis of spontaneous retroperitoneal fluid collection in adults.
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spelling pubmed-48392572016-05-02 Retroperitoneal Biloma due to Spontaneous Perforation of the Left Hepatic Duct Ishii, Kenjiro Matsuo, Kazuhiro Seki, Hiroaki Yasui, Nobutaka Sakata, Michio Shimada, Akihiko Matsumoto, Hidetoshi Am J Case Rep Articles Patient: Male, 82 Final Diagnosis: Retroperitoneal biloma due to spontaneous perforation of the left hepatic duct Symptoms: Abdominal pain • high fever Medication: — Clinical Procedure: Emergent operation Specialty: Gastroenterology and Hepatology OBJECTIVE: Rare disease BACKGROUND: Spontaneous perforation of the bile duct in adults is very rare, particularly in cases accompanied by retroperitoneal biloma. We report a patient with retroperitoneal biloma due to a spontaneous perforation of the left hepatic duct. CASE REPORT: An 82-year-old man was admitted to our institution with abdominal pain and a high fever. He had tenderness at the epi-mesogastrium. Computed tomography showed several stones in the gall bladder and common bile duct (CBD) and a few ascites. A substantial amount of fluid had collected from the dorsal stratum of the duodenum and pancreas head to the right paracolic gutter and anterior side of the right iliopsoas. Laboratory examination revealed a high inflammation score. He underwent emergent laparotomy. Biliary fluid was revealed after the mobilization of the pancreas head, duodenum, and right side of the colon. Bile duct perforation was suspected. Therefore, we exfoliated the dorsal side of the CBD to the cranial side, and intraoperative cholangiography was performed. However, the perforation site could not be detected. Cholecystectomy and choledocholithotomy were performed. A retrograde transhepatic biliary drainage tube was inserted, and primary closure of the CBD incision site was achieved. Postoperative cholangiography revealed leakage from the left hepatic duct near the caudate branch. CONCLUSIONS: There are a few reports of spontaneous bile duct perforation cases in the literature, particularly on infants or children with congenital anomalies, but it is rare in adults. It usually causes bile peritonitis, although bile duct perforation should be considered in the differential diagnosis of spontaneous retroperitoneal fluid collection in adults. International Scientific Literature, Inc. 2016-04-20 /pmc/articles/PMC4839257/ /pubmed/27094183 http://dx.doi.org/10.12659/AJCR.897612 Text en © Am J Case Rep, 2016 This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License
spellingShingle Articles
Ishii, Kenjiro
Matsuo, Kazuhiro
Seki, Hiroaki
Yasui, Nobutaka
Sakata, Michio
Shimada, Akihiko
Matsumoto, Hidetoshi
Retroperitoneal Biloma due to Spontaneous Perforation of the Left Hepatic Duct
title Retroperitoneal Biloma due to Spontaneous Perforation of the Left Hepatic Duct
title_full Retroperitoneal Biloma due to Spontaneous Perforation of the Left Hepatic Duct
title_fullStr Retroperitoneal Biloma due to Spontaneous Perforation of the Left Hepatic Duct
title_full_unstemmed Retroperitoneal Biloma due to Spontaneous Perforation of the Left Hepatic Duct
title_short Retroperitoneal Biloma due to Spontaneous Perforation of the Left Hepatic Duct
title_sort retroperitoneal biloma due to spontaneous perforation of the left hepatic duct
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4839257/
https://www.ncbi.nlm.nih.gov/pubmed/27094183
http://dx.doi.org/10.12659/AJCR.897612
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