SPONTANEOUS PERFORATION OF THE LEFT HEPATIC DUCT - A CASE-REPORT

We report on a patient with spontaneous perforation of the left hepati c duct who presented with abdominal pain, jaundice and fever. The corr ect diagnosis was not established until extravasation of contrast medi um from the left hepatic duct, as demonstrated by the cholangiogram, w as observed. The patient developed two bile-stained, intraperitoneal e ncapsulated fluid collections, which were diagnosed by ultrasonography , and high bilirubin levels in the fluid aspirated from the encapsulat ions, which were also found at operation. Closure of the perforation w ith sutures, decortication of the encapsulations and choledocholithoto my for stone extraction with T-tube insertion were performed. Recovery was complete at follow-up examinations.