Ruptured biliary cyst with biliary peritonitis – a case report

  • Cátia Ferreira Centro Hospitalar de Trás-os-Montes e Alto Douro, EPE
  • A. Melo Centro Hospitalar de Trás-os-Montes e Alto Douro
  • S. Silva Centro Hospitalar de Trás-os-Montes e Alto Douro
  • J. Lage Centro Hospitalar de Trás-os-Montes e Alto Douro
  • F. Próspero Centro Hospitalar de Trás-os-Montes e Alto Douro
  • B. Pinto Centro Hospitalar de Trás-os-Montes e Alto Douro
  • A. Ribeiro Centro Hospitalar de Trás-os-Montes e Alto Douro
  • A. Oliveira Centro Hospitalar de Trás-os-Montes e Alto Douro

Abstract

Introduction: Biliary cysts account for approximately 1-3% of all benign biliary diseases and their spontaneous rupture is extremely rare. The authors present a case where the initial event was biliary peritonitis. Case report: 72-year-old woman, admitted to the surgery ward with acute pancreatitis, with 2 Ranson criteria. Following the initial favourable evolution, there was a worsening in her clinical status, biliary obstruction, multiple organ dysfunction and admission to the Intensive Care Unit. She developed an acute abdomen, which led to an urgent laparotomy, with the diagnosis of a biliary peritonitis. A biliary tract decompression and a per-operatory cholangiography were performed, with no identification of the origin of the leak. It was necessary to perform a laparostomy. At a 48h-reviewing laparostomy, another cholangiography was performed, showing a ruptured biliary cyst, with contrast leak in the IVb hepatic segment. Conclusion: This case reports the peculiar etiology of a ruptured biliary cyst, with the presentation of a biliary peritonitis in a patient admitted with acute pancreatitis.

Downloads

Download data is not yet available.

Author Biographies

Cátia Ferreira, Centro Hospitalar de Trás-os-Montes e Alto Douro, EPE

Interno Complementar de Cirurgia Geral do CHTMAD

A. Melo, Centro Hospitalar de Trás-os-Montes e Alto Douro

Interno Complementar de Cirurgia Geral do CHTMAD

S. Silva, Centro Hospitalar de Trás-os-Montes e Alto Douro

Interno Complementar de Cirurgia Geral do CHTMAD

J. Lage, Centro Hospitalar de Trás-os-Montes e Alto Douro

Assistente Hospitalar de Cirurgia Geral do CHTMAD

F. Próspero, Centro Hospitalar de Trás-os-Montes e Alto Douro

Assistente Hospitalar de Cirurgia Geral do CHTMAD

B. Pinto, Centro Hospitalar de Trás-os-Montes e Alto Douro

Assistente Hospitalar de Cirurgia Geral do CHTMAD

A. Ribeiro, Centro Hospitalar de Trás-os-Montes e Alto Douro

Assistente Hospitalar de Cirurgia Geral do CHTMAD

A. Oliveira, Centro Hospitalar de Trás-os-Montes e Alto Douro

Diretor de Serviço de Cirurgia Geral do CTHMAD

References

1. Miliadis et al.: Spontaneous rupture of a large nonparasitic liver cyst: a case report. Journal of Medical Case Reports 2010 4:2.
2. Jablonska B. et al.: Biliary cysts: Etiology, diagnosis and management. World J Gastroenterol 2012 September 21; 18(35): 4801-4810.
3. Reid-Lombardo et al.: Hepatic Cysts and Liver Abscess. Surg Clin N Am 90 (2010) 679-697.
4. Maulik D. et al.: A rare case of spontaneous acalculus common bile duct perforation presenting as acute abdomen. Case Study Case Rep. 2014; 4(3): 99-103.
5. Torres O. et al.: Tratamento videolaparoscópico do cisto hepático. Rev. Col. Bras. Cir. 2009; 36(6): 493-497.
Published
2018-09-08
How to Cite
FERREIRA, Cátia et al. Ruptured biliary cyst with biliary peritonitis – a case report. Revista Portuguesa de Cirurgia, [S.l.], n. 44, p. 13 - 17, sep. 2018. ISSN 2183-1165. Available at: <https://revista.spcir.com/index.php/spcir/article/view/534>. Date accessed: 01 mar. 2024.
Section
Clinical Case