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肝总管自发性破裂合并急性胰腺炎:一例报告

Spontaneous rupture of the common hepatic duct associated with acute pancreatitis: a case report.

作者信息

Moussa Makram, Triki Wissem, Karray Omar, Marzouk Ines, Sami Bouchoucha

机构信息

Department of General Surgery, Habib Bougatfa Hospital, Bizerte, Tunisia.

Medical School of Tunis, Tunis El Manar University, Tunis, Tunisia.

出版信息

J Med Case Rep. 2017 Jun 21;11(1):165. doi: 10.1186/s13256-017-1283-6.

Abstract

BACKGROUND

Rupture of the common bile duct is a life-threatening condition, usually observed after a trauma or in association with choledocholithiasis or an obstructive tumor of the bile duct. However, a spontaneous rupture of the common bile duct is a rare entity.

CASE PRESENTATION

We report a new observation of a spontaneous rupture of the common bile duct, associated with biliary peritonitis and pancreatitis, in a 15-year-old North African girl. Etiological aspects, specificities of clinical presentation, means of diagnosis, as well as surgical and perioperative management are discussed.

CONCLUSIONS

The diagnosis of spontaneous rupture of the common bile duct is a challenge for both radiologist and surgeon. Beyond the difficulty of diagnosis, which requires radiological exploration, management of the subsequent biliary peritonitis involves urgent surgery, life-supporting measures, and close monitoring.

摘要

背景

胆总管破裂是一种危及生命的情况,通常在创伤后出现,或与胆总管结石病或胆管梗阻性肿瘤相关。然而,胆总管自发性破裂是一种罕见的情况。

病例报告

我们报告了一名15岁北非女孩发生胆总管自发性破裂并伴有胆汁性腹膜炎和胰腺炎的新病例。讨论了病因、临床表现的特点、诊断方法以及手术和围手术期管理。

结论

胆总管自发性破裂的诊断对放射科医生和外科医生来说都是一项挑战。除了诊断困难(需要进行放射学检查)外,后续胆汁性腹膜炎的处理还涉及紧急手术、生命支持措施和密切监测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c23/5479041/72883af16607/13256_2017_1283_Fig1_HTML.jpg

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