Acute acalculous cholecystitis coexisting with spontaneous intra-hepatic bile duct rupture: a rare case

作者：Shao, Hui-Jiang; Lu, Bao-Chun; Xu, Huan-Jian; Shen, Zhi-Hong^*

来源：International Journal of Clinical and Experimental Medicine, 2016, 9(2): 3800-3803.

• Acute acalculous cholecystitis
• intra-hepatic bile duct
• bile peritonitis
• simultaneous rupture

Rare cases of acute acalculous cholecystitis (AAC) coexisting with spontaneous rupture of intra-hepatic bile duct (IHBD) are available. In this case, a male patient aged 81 year-old with a history of diabetes and hypertension was admitted to our hospital due to pain in right upper abdomen. The patient was initially diagnosed with AAC with no signs of peritonitis. Two days after conservative therapy, sharp pain in abdomen was reported together with presence of peritonitis signs. Ultrasonic examination and abdominal paracentesis revealed bile peritonitis. Accumulation of bile and rupture of bile duct at the left liver were revealed after exploratory laparotomy. The patient was finally diagnosed with AAC coexisting with rupture of IHBD. For the treatment, removal of gallbladder and suturing of rupture was performed, followed by T-tube drainage. After discharge, the patient showed no complications or adverse events during the 12-month follow up. For AAC patients concurrent with bile peritonitis, special cares should be taken to identify the rupture of IHBD. Besides surgery, a systematic evaluation of the bile duct is necessary to exclude the possibilities of rupture of IHBD.

• 出版日期2016
• 单位浙江大学; 绍兴市人民医院