RSS-Feed abonnieren
DOI: 10.1055/s-0042-1756284
An Unusual Cause of Biliary Peritonitis on the Background of Acute Pancreatitis: A Case Report
Abstract
Introduction Acute pancreatitis can cause a wide variety of local complications, sometimes pretty unusual. In the present report, we present a rather unusual cause of biliary peritonitis on the background of acute pancreatitis.
Case Presentation A 41-year-old female patient with biliary acute pancreatitis and concomitant choledocholithiasis required an urgent laparotomy due to signs of sepsis and peritoneal irritation after a trial of conservative management. During laparotomy, the diagnosis of biliary peritonitis was established. Surprisingly, a residual gallstone obstructing the common bile duct at the level of the ampulla was causing bile to reflux, through the common channel, into the main pancreatic duct and subsequently into a partially ruptured acute pancreatic necrotic collection.
Conclusion Dealing with the unexpected is a constant challenge for the surgical team dealing with acute pancreatitis patients. Although deferring surgical intervention during the course of acute pancreatitis, as much as possible, is the ideal strategy, this is not always possible. Deciding the treatment strategy based on the patients' clinical condition represents the most appropriate approach.
Publikationsverlauf
Eingereicht: 24. Februar 2022
Angenommen: 01. August 2022
Artikel online veröffentlicht:
02. September 2022
© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
References
- 1 Banks PA, Bollen TL, Dervenis C. et al; Acute Pancreatitis Classification Working Group. Classification of acute pancreatitis–2012: revision of the Atlanta classification and definitions by international consensus. Gut 2013; 62 (01) 102-111
- 2 Sgantzou IK, Samara AA, Diamantis A, Karagiorgas GP, Zacharoulis D, Rountas C. Pseudoaneurysm of gastroduodenal artery and pulmonary embolism: rare co-incidence of two complications of pancreatitis. J Surg Case Rep 2020; 2020 (02) rjz407 DOI: 10.1093/jscr/rjz407.
- 3 Bezmarević M, van Dijk SM, Voermans RP, van Santvoort HC, Besselink MG. Management of (Peri)pancreatic collections in acute pancreatitis. Visc Med 2019; 35 (02) 91-96
- 4 Ishii K, Matsuo K, Seki H. et al. Retroperitoneal biloma due to spontaneous perforation of the left hepatic duct. Am J Case Rep 2016; 17: 264-267
- 5 Laway MA, Bakshi IH, Shah M, Paray SA, Malla MS. Biliary peritonitis due to spontaneous perforation of choledochus: a case report. Indian J Surg 2013; 75 (Suppl. 01) 96-98
- 6 Chardot C, Iskandarani F, De Dreuzy O. et al. Spontaneous perforation of the biliary tract in infancy: a series of 11 cases. Eur J Pediatr Surg 1996; 6 (06) 341-346
- 7 Kerstein MD, McSwain NE. Spontaneous rupture of the common bile duct. Am J Gastroenterol 1985; 80 (06) 469-471
- 8 Moussa M, Triki W, Karray O, Marzouk I, Sami B. Spontaneous rupture of the common hepatic duct associated with acute pancreatitis: a case report. J Med Case Reports 2017; 11 (01) 165 DOI: 10.1186/s13256-017-1283-6.
- 9 Kumar A, Kataria R, Chattopadhyay TK, Karak PK, Tandon RK. Biliary peritonitis secondary to perforation of common bile duct: an unusual presentation of chronic calcific pancreatitis. Postgrad Med J 1992; 68 (804) 837-839
- 10 van Santvoort HC, Bakker OJ, Bollen TL. et al; Dutch Pancreatitis Study Group. A conservative and minimally invasive approach to necrotizing pancreatitis improves outcome. Gastroenterology 2011; 141 (04) 1254-1263
- 11 Working Group IAP/APA Acute Pancreatitis Guidelines. IAP/APA evidence-based guidelines for the management of acute pancreatitis. Pancreatology 2013; 13 (4, Suppl 2) e1-e15
- 12 van Baal MC, van Santvoort HC, Bollen TL, Bakker OJ, Besselink MG, Gooszen HG. Dutch Pancreatitis Study Group. Systematic review of percutaneous catheter drainage as primary treatment for necrotizing pancreatitis. Br J Surg 2011; 98 (01) 18-27
- 13 Rodriguez JR, Razo AO, Targarona J. et al. Debridement and closed packing for sterile or infected necrotizing pancreatitis: insights into indications and outcomes in 167 patients. Ann Surg 2008; 247 (02) 294-299
- 14 Leppäniemi A, Tolonen M, Tarasconi A. et al. 2019 WSES guidelines for the management of severe acute pancreatitis. World J Emerg Surg 2019; 14: 27 DOI: 10.1186/s13017-019-0247-0.