Spontaneous Perforation of the Extrahepatic Bile Duct in Adults: Report of Two Cases

自發性成人肝外膽管穿孔－兩病例報告

蘇峰毅(Feng-I Su) ； 高常發(Sheung-Fat Ko) ； 沈陳石銘(Shyr-Ming Sheen-Chen) ； 李文輝(Wen-Huei Lee) ； 劉柏屏(Po-Ping Liu)

《Journal of Emergency Medicine, Taiwan》 9卷4期 (2007/12) Pp. 105-109

摘要

引起膽道穿孔常見的原因可能有感染，外傷或遠端總膽管阻塞，而其中自發性的膽道穿孔更為少見且在臨床上要確定診斷非常困難。我們報告兩位病例以腹部電腦斷層上所表現的膽道周邊積液與膽管壁缺損在術前得到懷疑診斷，並在之後的手術中加以證實，因此我們認為腹部電腦斷層可以提供有效的診斷線索而進一步及早安排手術治療。

關鍵字

自發性 ； 膽道穿孔 ； 肝外膽管 ； 成人 ； 電腦斷層 ； 診斷

並列摘要

Bile duct perforation may be induced by infection, trauma and obstruction of the distal common bile duct. Spontaneous perforation of the extrahepatic bile duct in adults is rare and an accurate diagnosis is difficult. We report the specific computed tomography (CT) findings in two patients who presented with peribiliary fluid accumulation and disrupted outline of the bile duct. Both patients underwent surgery with confirmation of the CT findings and smooth post-operative course were obtained. We believe that CT scan can offer an accurate diagnosis of this rare disease and prompt early surgical intervention.

並列關鍵字

spontaneous ； bile duct perforation ； extrahepatic bile duct ； Adults ； computed tomography ； diagnosis