Kerstein M D, McSwain N E
Am J Gastroenterol. 1985 Jun;80(6):469-71.
Spontaneous rupture of the common bile duct is rare, but may result from increased intraductal pressure with associated calculous erosion and necrosis of the bile duct wall secondary to thrombosis. Two cases are reported; one clearly related to calculous erosion and the other unexplained. Survival depends on early diagnosis. Aggressive supportive therapy, including Swan-Ganz catheter, intensive care unit monitoring, and appropriate antibiotics, are mandatory. Only with early operation to alleviate sepsis and decompression of the biliary system can better survival be expected.
胆总管自发性破裂罕见，但可能因导管内压力升高，伴有结石侵蚀及继发于血栓形成的胆管壁坏死所致。本文报告两例；一例明显与结石侵蚀有关，另一例原因不明。生存取决于早期诊断。积极的支持治疗，包括使用 Swan-Ganz 导管、重症监护病房监测及适当的抗生素，是必不可少的。只有早期手术以减轻脓毒症并使胆道系统减压，才有望获得更好的生存。
