BILE PERITONITIS DUE TO SPONTANEOUS PERFORATION OF THE COMMON DUCT

1 July 1954

journal article
research article
Published by American Medical Association (AMA) in Archives of Surgery

Vol. 69 (1) , 77-80
https://doi.org/10.1001/archsurg.1954.01270010079011

Abstract

BILE PERITONITIS due to a spontaneous perforation of the common duct without antecedent history of trauma, previous surgery or obstructive calculi is exceedingly rare. Spontaneous perforation of the common bile duct in this category has been reported at infrequent intervals, possibly due to one cause or to a combination of causes which include (a) increased intraductal pressure due to spasm of the sphincter of Oddi; (b) intramural infection; (c) diverticulum; (d) necrosis of the part of the wall due to a mural vessel thrombosis; (e) necrosis of the wall secondary to a calculus, and (f) reflux pancreatic secretions and tissue digestion.* As early as 1912, McWilliams¹ reviewed 90 cases of bile peritonitis due to spontaneous rupture of the biliary tract of all causes and showed that 91% occurred in the gall bladder, 4.4% in the common duct, 3.3% in the cystic duct, and 1.1% in the hepatic duct. This

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