Enell H, Cavell B, Malmfors G
Acta Paediatr Scand. 1979 Jul;68(4):625-6. doi: 10.1111/j.1651-2227.1979.tb05070.x.
An 18-week-old baby boy suffered an episode of acute abdominal symptoms followed by a silent period with mild obstructive jaundice, abdominal distension and failure to thrive. During the clinical work-up he deteriorated suddenly, with progressive abdominal distension and ascites. At laparotomy a perforation of the common bile duct with bile peritonitis was found. Spontaneous perforation of the common bile duct is seldom listed as a cause of obstructive jaundice. The clinical picture is characteristic. Awareness of this diagnosis may help to avoid time-consuming and unnecessary investigations and to lead to surgical treatment in good time.
一名18周大的男婴出现了急性腹部症状，随后进入一段无症状期，伴有轻度梗阻性黄疸、腹胀和发育不良。在临床检查过程中，他突然病情恶化，腹胀和腹水逐渐加重。剖腹探查时发现胆总管穿孔并伴有胆汁性腹膜炎。胆总管自发性穿孔很少被列为梗阻性黄疸的病因。临床表现具有特征性。认识到这一诊断有助于避免耗时且不必要的检查，并及时进行手术治疗。
