Laway Mushtaq A, Bakshi Iftikhar H, Shah Mubbashir, Paray Showkat A, Malla Mohd Sadiq
Department of General and Minimal Access Surgery, Sher-i- Kashmir Institute of Medical Sciences, F-24, C-Block, Married Doctors Hostel, Kashmir, India.
Department of Anesthesia and Critical Care, Sher-i- Kashmir Institute of Medical Sciences, Kashmir, India.
Indian J Surg. 2013 Jun;75(Suppl 1):96-8. doi: 10.1007/s12262-011-0351-1. Epub 2011 Nov 23.
Spontaneous perforation of common bile duct (CBD) in an adult is an exceedingly rare phenomenon. It is mostly seen in infants due to congenital anomalies. The diagnosis of biliary tract perforations is often delayed due to their nonspecific symptoms, which results in high morbidity. Early diagnosis and aggressive therapy are mandatory to alleviate this condition. Delayed diagnoses and treatment may have more serious consequences in terms of morbidity as well as mortality. We herein report spontaneous perforation of CBD in a middle-aged male who presented to our accident and emergency department with acute abdominal pain. Exploratory laparotomy revealed a small perforation with necrosed margins in the supraduodenal part of CBD, which was managed by a T-tube drain. However, no apparent cause for the perforation was found.
成人胆总管自发性穿孔是一种极为罕见的现象。它多见于婴儿,因先天性异常所致。由于胆道穿孔症状不具特异性,其诊断常常延迟,导致高发病率。早期诊断和积极治疗对于缓解病情至关重要。延迟诊断和治疗在发病率及死亡率方面可能会造成更严重的后果。我们在此报告一例中年男性胆总管自发性穿孔病例,该患者因急性腹痛就诊于我院急诊科。剖腹探查发现胆总管十二指肠上段有一个边缘坏死的小穿孔,通过放置T形管引流进行处理。然而,未发现穿孔的明显病因。