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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...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
International Scientific Literature, Inc.
2016
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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. |
format | Online Article Text |
id | pubmed-4839257 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | International Scientific Literature, Inc. |
record_format | MEDLINE/PubMed |
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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