Spontaneous gallbladder perforation--an unusual presentation of carcinoma of the pancreas.

A 50 year old man with a two month history of upper abdominal pain and a one month history of anorexia and weight loss, presented with icterus and evidence of peritonitis. Laparotomy revealed biliary peritonitis which had been caused by a rupture of the fundus of the gallbladder. The common bile duct was dilated and there was a large growth in the head of the pancreas with multiple hepatic metastases. A cholecystojejunostomy and gastrojejunostomy were done and the patient had an uneventful recovery.