2020 Volume 34 Issue 2 Pages 194-199
A 83-year-old female was visited previous hospital for upper abdominal pain. As a result of examination, the upper gastrointestinal perforation was suspected and she was urgently transported to our hospital. She had treated with hemodialysis for chronic renal failure. Liver disfunction were detected on blood examination. Contrast-enhanced abdominal computed tomography (CT) revealed intra-abdominal free air and fluid collection around the duodenum and the retroperitoneum. We diagnosed the patient as duodenal perforation and performed emergency surgery. Perforation and necrosis detected in the common bile duct. Since no gall stones were found, we finally diagnosed as idiopathic common bile duct perforation, and an emergency cholecystectomy and extrahepatic bile duct resection were performed. X-ray examination showed a minor leakage from the stump of bile duct on the duodenal side. Drain was removed on 42nd postoperative day and patient was transferred on 71st postoperative day. In this case, it is considered that interrupted blood flow of common bile duct led to perforation of the bile duct.
