Spontaneous bile duct perforation causing biliary peritonitis in chronic pancreatitis

Spontaneous bile duct perforation causing biliary peritonitis in chronic pancreatitis

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Spontaneous perforation of the extrahepatic biliary system is a rare presentation of chronic pancreatitis.Very few cases of bile duct perforation have been reported DUO ABSOLUT ARNICA in adults.It is rarely correctly diagnosed preoperatively in an emergency.A 25-year-old male presented at the surgical emergency with a long history of abdominal pain and repeated episodes of vomiting, after 4 days of duration, he came with pain abdomen, and distension with evidence of generalized peritonitis.The diagnosis made was perforative peritonitis for which he underwent an exploratory laparotomy with cholecystectomy.

A single perforation was presented on the anterolateral surface of the supraduodenal part of the common bile duct (CBD) which was repaired with the help of T-tube.On the 10th post-operative day, T-tube cholangiogram shows two radio-opaque dense shadows in the main pancreatic duct which shows chronic pancreatitis and lower CBD stricture.Spontaneous perforation of the extrahepatic bile duct is a rare but important presentation of chronic pancreatitis in adults causing biliary peritonitis.Therefore, awareness of the clinical BIOTIN SHAMPOO presentation, expert ultrasound examination, and surgery are important aspects of the management.